Early signs of microvascular complications in pediatric patients with short duration of type 1 diabetes mellitus seen in southeast Nigeria
Open Access
- 1 January 2019
- journal article
- research article
- Published by Medknow in Annals of African Medicine
- Vol. 18 (4), 200-205
- https://doi.org/10.4103/aam.aam_5_19
Abstract
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. Résumé Objectif: abstrait Déterminer la prévalence des signes précoces de complications microvasculaires chez les adolescents âgés de 9 à 19 ans ayant une courte durée de T1DM par dépistage de la rétinopathie et de la néphropathie. Méthodes: Une étude transversale et des sujets ont été inscrits consécutivement de la clinique d'endocrinologie à l'hôpital fédéral d'enseignement Abakaliki.L'examen physique et l'ophtalmose mydriatique ont été menés. Trois spécimens d'urine de tache tôt le matin pour le rapport d'albumine/créatinine ont été estimés 3 mois d'intervalle.Des niveaux de créatinine de sérum ont été estimés et le taux glomerular de filtration calculé.L'hémoglobine glycosylated (HbA1c) a été déterminée. Résultats: 24 sujets ont participé, Quinze (62,5%) étaient des mâles et l'âge moyen au diagnostic était de 12,4 à 2,3 ans.La durée moyenne du diabète était de 23,8 à 20,6 mois. Leur HbA1c moyen était de 11,4%.La rétinopathie a été vue dans 16.7% tandis que 33.3% a eu le microalbuminuria. La tension artérielle se situe entre le 50e et le 90e percentile pour tous les participants. Conclusion: Les signes de complication microvasculaire se manifestent tôt chez les enfants et les adolescents atteints de TIDM dans le sud-est du Nigeria.Contrairement à la croyance que les complications microvasculaires cliniquement évidentes sont rarement vues parmi des enfants avec T1DM.Un mauvais contrôle glycémique et la puberté sont des facteurs de risque importants.Keywords
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