Background: Clinically evident microvascular complications are rarely seen among children and adolescents with type 1 diabetes mellitus (T1DM), although early signs develop during childhood and accelerate during puberty.
Aim: The aim of this study was to determine the prevalence of early signs of microvascular complications in children and adolescents aged 9-19 years with a short duration of T1DM by screening for retinopathy and nephropathy.
Methods: A cross-sectional study and participants were consecutively enrolled from the Endocrinology Clinic at Federal Teaching Hospital, Abakaliki. Physical examination and mydriatic ophthalmoscopy were conducted. Three early morning spot urine specimens for albumin/creatinine ratio were estimated 3 months apart. Serum creatinine levels were estimated, and the glomerular filtration rate was calculated. Glycosylated hemoglobin (HbA1c) was determined.
Results: Twenty-four individuals participated, 15 (62.5%) were male and the mean age at diagnosis was 12.4 ± 2.3 years. The mean duration of diabetes was 23.8 ± 20.6 months. The mean HbA1c was 11.4%. Retinopathy was seen in 16.7%, whereas 33.3% had microalbuminuria. Blood pressure range was within the 50th-90th percentile for all the participants.
Conclusion: The study outcome demonstrated a high prevalence of early signs of microvascular complications such as retinopathy and nephropathy among youths with short duration of T1DM. Poor glycemic control, if not halted, is associated with early signs of microvascular complications which may become clinically evident; contrary to the belief that they are rare in childhood.
Keywords: Diabetes; microalbuminuria; microvascular complications; retinopathy; short duration.
Conflict of interest statement
The Role of Osteopontin in the Pathogenesis and Complications of Type 1 Diabetes Mellitus in ChildrenMA Talat et al. J Clin Res Pediatr Endocrinol 8 (4), 399-404. PMID 27353561.This study shows that increased osteopontin levels are independently associated with T1DM in pediatric patients and supports the hypothesis that osteopontin may have a ro …
Assessment of Serum Levels of Soluble CD40L in Egyptian Children and Adolescents With Type 1 Diabetes Mellitus: Relationship to Microalbuminuria and Glycemic ControlKA Metwalley et al. Indian J Endocrinol Metab 17 (6), 1024-9. PMID 24381879.The high serum sCD40L levels in children and adolescents with T1DM particularly in those with microalbminuria and its positive correlation with diabetes duration, urinary …
[A 20-year Prospective Follow-Up Study to Evaluate the Development of Retinopathy and Nephropathy After the Onset of Type 1 Diabetes Mellitus: Contribution of Glycemic Control and Metabolic Memory]LL Bolotskaya et al. Ter Arkh 89 (10), 17-21. PMID 29171465.Цель исследования. Оценка динамики уровня гликированного гемоглобина (HbA1c) в течение 20 лет от момента дебюта сахарного диабета 1-го типа (СД-1) и сопоставление ее с ра …
[Microvascular and Macrovascular Complications in Children and Adolescents With Type 1 Diabetes Mellitus]EE Fröhlich-Reiterer et al. Wien Med Wochenschr 160 (15-16), 414-8. PMID 20812053. - ReviewDiabetes-related microvascular and macrovascular complications, as retinopathy, nephropathy and neuropathy are life-threatening complications in children and adolescents …
Intensive Glucose Control Versus Conventional Glucose Control for Type 1 Diabetes MellitusB Fullerton et al. Cochrane Database Syst Rev 2014 (2), CD009122. PMID 24526393. - ReviewTight blood sugar control reduces the risk of developing microvascular diabetes complications. The evidence of benefit is mainly from studies in younger patients at early …
- Marcovecchio ML, Chiarelli F. Microvascular disease in children and adolescents with type 1 diabetes and obesity. Pediatr Nephrol. 2011;26:365–75. - PubMed
- DCCT Research Group. Effect of intensive diabetes treatment on the development and progression of long term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes control and complications trial. J Pediatr. 1994;125:177–88. - PubMed
- Donaghue KC, Chiarelli F, Trotta D, Allgrove J, Dahl-Jorgensen K. Microvascular and macrovascular complications associated with diabetes in children and adolescents. Pediatr Diabetes. 2009;10(Suppl 12):195–203. - PubMed
- Harris MI, Hadden WC, Knowler WC, Bennett PH. Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in US population aged 20-74 years. Diabetes. 1998;36:523–34. - PubMed
- Lurbe E, Redon J, Kesani A, Pascual JM, Tacons J, Alvarez V, et al. Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. N Engl J Med. 2002;347:797–805. - PubMed