Infant and Toddler Type 1 Diabetes
Open Access
- 13 March 2012
- journal article
- research article
- Published by American Diabetes Association in Diabetes Care
- Vol. 35 (4), 829-833
- https://doi.org/10.2337/dc11-1489
Abstract
OBJECTIVE: To compare the effect of the prepubertal duration of diabetes on the occurrence of complications in two groups of patients after the same number of years of the disease. RESEARCH DESIGN AND METHODS: This multicenter study enrolled 105 patients aged 16–40.3 years; 53 were prepubertal at diagnosis (aged 0–3) and 52 were pubertal (Tanner stage) and aged 9–14.9. The mean duration of disease was 19.8 and 19.5 years for prepubertal and pubertal patients, respectively. In all patients, retinal photographs were taken and centrally graded. Urinary albumin excretion (UAE; 86 case subjects), blood pressure (BP; 89 case subjects), and lifetime HbA1c (72 case subjects) were also evaluated. RESULTS: The prevalence of diabetic retinopathy (DR) was higher in pubertal than in prepubertal patients, both for any grade DR (71 vs. 40%, P = 0.002) and for mild or more severe DR (P = 0.005). The prevalence of abnormal UAE was not different in the two groups. Hypertension was found only in three patients, all pubertal at diagnosis. In the small group with moderate-to-severe DR, lifetime HbA1c levels, as percentages above the upper normal reference value, were higher (P < 0.01) in prepubertal than in pubertal patients. CONCLUSIONS: If diabetes is diagnosed in infants or toddlers and the prepubertal duration of diabetes is very long, the patients seem to be protected against DR. This protection disappears if lifetime metabolic control is bad. Instead, when onset is at puberty, the DR risk is higher and less dependent on metabolic control and may be influenced by age-related factors, such as BP.This publication has 17 references indexed in Scilit:
- Is Pubertal Onset a Risk Factor for Blindness and Renal Replacement Therapy in Childhood-Onset Type 1 Diabetes in Japan?Diabetes Care, 2007
- Age at Onset of Childhood-Onset Type 1 Diabetes and the Development of End-Stage Renal DiseaseDiabetes Care, 2006
- The significance of the prepubertal diabetes duration for the development of retinopathy and nephropathy in patients with type 1 diabetesJournal of Diabetes and its Complications, 2004
- Pre-pubertal onset of type 1 diabetes and appearance of retinopathyDiabetes & Metabolism, 2004
- Early Glycemic Control, Age at Onset, and Development of Microvascular Complications in Childhood-Onset Type 1 DiabetesDiabetes Care, 2004
- Effects of Duration and Age at Onset of Type 1 Diabetes on Preclinical Manifestations of NephropathyDiabetes, 2003
- Do All Prepubertal Years of Diabetes Duration Contribute Equally to Diabetes Complications?Diabetes Care, 2003
- Diabetic retinopathy in pediatric patients with type-1 diabetes: Effect of diabetes duration, prepubertal and pubertal onset of diabetes, and metabolic controlThe Journal of Pediatrics, 1998
- The Effect of Prepubertal Diabetes Duration on Diabetes: Microvascular Complications in Early and Late AdolescenceDiabetes Care, 1997
- Contribution of Diabetes Duration Before Puberty to Development of Microvascular Complications in IDDM SubjectsDiabetes Care, 1989