Retinopathy screening in patients with Type 1 diabetes diagnosed in young age using a non-mydriatic digital stereoscopic retinal imaging

N. Minuto, V. Emmanuele, M. Vannati, C. Russo, C. Rebora, S. Panarello, A. Pistorio, R. Lorini, G. D'Annunzio

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Abstract

Background: Diabetic retinopathy seriously impairs patients' quality of life, since it represents the first cause of blindness in industrialized countries. Aim: To estimate prevalence of retinopathy in young Type 1 diabetes patients using a non-mydriatic digital stereoscopic retinal imaging (NMDSRI), and to evaluate the impact of socio-demographic, clinical, and metabolic variables. Subjects and methods: In 247 young patients glycated hemoglobin (HbA1c), gender, age, pubertal stage, presence of diabetic ketoacidosis (DKA), HLA-DQ heterodimers of susceptibility for Type 1 diabetes, and β-cell autoimmunity at clinical onset were considered. At retinopathy screening, we evaluated age, disease duration, pu bertal stage, body mass index (BMI-SDS), insulin requirement, HbA1c levels, other autoimmune diseases, diabetes-related complications, serum concentrations of cholesterol and triglycerides, systolic and diastolic blood pressure. Results: Retinopathy was found in 26/247patients: 25 showed background retinopathy, and 1 had a sight-threatening retinopathy. A significant relationship between retinopathy and female gender (p=0.01), duration of disease ≥15 yr (p65 mg/dl (p=0.012) and mean HbA1c ≥7.5% or >9% (p=0.0014) were found at the multivariate logistic analysis. Conclusions: Metabolic control is the most important modifiable factor and promotion of continuous educational process to reach a good metabolic control is a cornerstone to prevent microangiopathic complications. Symptoms appear when the complication is already established; a screening program with an early diagnosis is mandatory to prevent an irreversible damage.

Original languageEnglish
Pages (from-to)389-394
Number of pages6
JournalJournal of Endocrinological Investigation
Volume35
Issue number4
DOIs
Publication statusPublished - Apr 2012

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Keywords

  • Diabetes complications
  • Diabetes mellitus Type 1
  • Diabetic retinopathy
  • Pediatrics
  • Prevention and control

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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