Diabetes complication screening in 937 children and adolescents

Results are presented of diabetes complication screening in children and ad olescents aged 6-20 years. Their diabetes duration was 0.02-18.4 yr and med ian HbA(1c) over the preceding 36 months was 8.4% [IQR 7.8-9.3]. Gradable r etinal photographs were obtained in 937: 110 less than 11 years (<11 yr Gp) . Albumin excretion rate (AER) was obtained from 3 timed overnight urine co llections in 691: 100 in <11yr Gp. Early retinopathy was found in 27% (9% in <11yr Gp), Microalbuminuria (AER greater than or equal to 20 mu g/min) was found in 4%, Significant individu al risk factors for both complications were higher blood pressure, choleste rol, HbA(1c), pubertal staging, older age and longer diabetes duration. Usi ng multiple logistic regression, significant risk factors for retinopathy w ere longer duration and older age and in addition higher HbA(1c). Diabetes complication screening detected early subclinical disease in child ren and adolescents who may benefit from lowering blood pressure and improv ing metabolic control, Screening should commence after five years of durati on in young children, and after two years of duration in adolescents.