Background: There is currently limited data published on the prevalence of diabetic eye disease in children and young people (CYP) with type 1 diabetes mellitus (T1DM), yet diabetic retinopathy remains one of the commonest causes of blindness in young adults.
Objectives: To determine the risk and prevalence of diabetic retinopathy and to evaluate the risk factors associated with diabetic retinopathy in CYP with T1DM.
Methods: All CYP with T1DM between 12 and 18 years registered with the regional diabetic retinopathy screening programme were evaluated between 2012 and 2013 in four paediatric diabetes centres in the Northwest of England. Patients who had evidence of diabetic retinopathy were reviewed to identify risk factors for presence or absence of diabetic retinopathy. Risk factors assessed were duration of diabetes (years), pubertal status, mean blood pressure, mean urine albumin creatinine ratio, and mean HbA1c during the preceding 12 months. All patients underwent mydriatic three-field 45 degree fundus photography.
Results: 237 patients between the ages 12 and 18 years were included in the study from four paediatric diabetes centres. The prevalence of diabetic retinopathy was 11%. Out of 27 patients with evidence of diabetic retinopathy, 44% were reported as background changes, and 56% were stage 1 retinopathy. Significant risk factors for diabetic retinopathy disease in the population using univariate analyses were duration of diabetes, puberty, age at diagnosis, and mean HbA1c in the preceding 12 months. Multivariate logistic regression analysis found age of diagnosis (P=0.04) and mean HbA1c as significant independent risk factors for presence of diabetic retinopathy (P=0.02).
Conclusions: The prevalence of diabetic retinopathy in this paediatric population in our study was 11%. Early age at diagnosis and poor metabolic control are independent risks factor for diabetic retinopathy. Implementation of national screening programmes should take account of early detection of retinopathy in CYP with T1DM.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology