Diabetic microvascular complications in type 1 diabetic chidren and adolescents attending the Chris Hani Baragwanath Academic Hospital (CHBAH) Paediatric Diabetic Clinic

Abstract

Background: Diabetic retinopathy and nephropathy are common complications in patients with insulin dependent diabetes mellitus (IDDM). This study describes the prevalence of these microvascular complications and their associated risk factors in children with IDDM, attending the Chris Hani Baragwanath Academic Hospital (CHBAH) between June 2015 and January 2016. Methods: Participants between 9 and 19 years were screened for diabetic retinopathy and nephropathy using indirect ophthalmoscopy and random urine albumin to creatinine ratios respectively. Demographic, anthropometric, disease related and biochemical characteristics were described. Results: The mean age of the participants was 11,96 years and the mean duration of diabetes was 1,88 years. The mean HbA1c was 12,4%, and 67,7% of admissions were due to DKA. Of the 34 children with IDDM, confirmed nephropathy was found in one participant. No new retinopathy was diagnosed and one participant was known to have cataracts. However, 26,5% of participants defaulted retinal screening. Conclusions: Notwithstanding the finding that the patients in the cohort have poorly controlled diabetes (as ascertained by their HbA1c levels), a low prevalence of diabetic complications (ie. nephropathy and retinopathy) was found. This may be explained by the short disease duration in the study population. A young age at diagnosis and poor glycaemic control indicates a cohort at high risk, who will require continued screening.