We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Rates, Risk Factors, and Progression of Diabetic Retinopathy in Children with Type 1 Diabetes: A 15‐Year Retrospective Study from a Regional Center in New Zealand.
- Authors
Winter, Thomas; Derraik, José G. B.; Jefferies, Craig A.; Hofman, Paul L.; Shand, James A. D.; Braatvedt, Geoffrey D.; Misra, Stuti L.; Hoffman, Robert P.
- Abstract
Aims. Diabetic retinopathy (DR) is the primary microvascular complication associated with diabetes. Evidence on DR prevalence among children in New Zealand is scarce. We examined DR rates and associated risk factors in youth with type 1 diabetes (T1D) aged <16 years receiving care from a regional diabetes service in January 2006–December 2020. Materials and Methods. DR diagnosis followed the International Society for Pediatric and Adolescent Diabetes guidelines. The study included 646 participants; mean age (±SD) at T1D diagnosis was 7.4 ± 3.6 years, 47% were female, and 69% identified as NZ Europeans. Results. The initial DR screening occurred at a mean age of 12.6 ± 2.4 years and 5.2 ± 2.2 years after T1D diagnosis. At the first DR screen, 23.5% of participants (152/646) were diagnosed with DR: 69.1% (105/152) with minimal, 30.3% (46/152) with mild, and one moderate case (0.7%). Older age at diagnosis (p = 0.029) and longer diabetes duration (p = 0.015) were predictors of DR at first screen. Patients with at least one positive DR screen had a higher average HbA1c at their first screen (+2.6 mmol/mol; p = 0.042). Overall, 55.6% (359/646) of patients had a positive DR screen, whose worst grade was mostly either minimal (58.2%) or mild (40.7%) DR, with only three moderate cases (0.8%) and one severe (0.3%). Children diagnosed with T1D before age 10 were 72% more likely to have DR than older children (p < 0.0001), and DR risk was 32% and 41% higher among Pacific children than NZ European (p = 0.008) and Māori (p = 0.014) children. Lastly, the only predictor of DR at discharge from paediatric services was HbA1c at the first screen (p < 0.0001). Conclusions. In this regional cohort of children with T1D, there was a high rate of low‐grade DR overall and at first retinal screen, with an increasing rate until transfer to adult services. Our findings underscore the importance of ongoing DR screening, reducing glycaemic levels, and supporting vulnerable high‐risk groups.
- Subjects
NEW Zealand; TYPE 1 diabetes; RISK assessment; RESEARCH funding; GLYCOSYLATED hemoglobin; DIABETIC retinopathy; RETROSPECTIVE studies; SEVERITY of illness index; AGE distribution; POPULATION geography; DISEASE progression; DISEASE risk factors; DISEASE complications; ADOLESCENCE; CHILDREN
- Publication
Pediatric Diabetes, 2024, Vol 2024, p1
- ISSN
1399-543X
- Publication type
Article
- DOI
10.1155/2024/5893771