Background: Screening guidelines for vascular complications in children with type 1 diabetes (T1DM) are based on results from Diabetes Control and Complications Trial (DCCT) and its follow-up, the Epidemiology of Diabetes Interventions and Complications (EDIC) trial. These studies established conclusively that early and intensive diabetes care improves long-term outcomes.
Objective and hypotheses: To establish screening practices and prevalence of vascular complications in a cohort of paediatric patients with T1DM in Cork University Hospital (CUH).
Methods: A retrospective review of all data currently available over the last 24 months in the paediatric diabetes clinic in CUH was carried out and compared to ISPAD Guidelines 2014. HbA1c, blood pressure (BP), fasting lipid profile, urine albumin to creatinine ratio (UACR) and retinal screening for each patient were recorded.
Results: 313 children with T1DM (148 girls, 165 boys) aged 118 years (mean 11.99±3.7) were analysed. The mean HbA1c was 68.3±15.02 mmol/mol. 235 patients (75%) had HbA1c above the optimal concentration 58 mmol/mol with 26% (81 patients) at the high risk (>74.9 mmol/mol). Retinal screening showed 2% (six children) as having background retinopathy. BP screening was obtained for 87% (272 children) with 26% (81 cases) having an elevated systolic BP (>140/90). Lipid screening was documented for 75% (235 children), with 32% (100 children) displaying elevated total cholesterol, 33% (103 children) elevated LDL cholesterol, 11% (34 children) elevated triglycerides and 3% (ten cases) with suboptimal HDL cholesterol. UACR was recorded for 65% (203 cases), with 4% (12 cases) having a UACR >3 mg/mmol (ISPAD 2014).
Conclusion: The results of this cohort study are consistent with the international literature. They identify what routinely happens in the Paediatric Diabetes Clinic and highlights the vascular risk profile of these children. These baseline data will be followed prospectively for the next 10years and will help to inform clinical care and service development of children with T1DM in Ireland.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology