Retinopathy screening in patients with Type 1 diabetes diagnosed in young age using a non-mydriatic digital stereoscopic retinal imaging
N. Minuto1, V. Emmanuele1, M. Vannati1, C. Russo1, C. Rebora1, S. Panarello2, A. Pistorio3, R. Lorini1, and G. d’Annunzio1
1Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute; 2Department of Ophthalmology; 3Epidemiology and Biostatistic Service, Scientific Directorate, IRCCS G. Gaslini Institute, Genoa, Italy

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 (p<0.0001), serum triglycerides levels >65 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. (J. Endocrinol. Invest. 35: 389-394, 2012) ©2012, Editrice Kurtis

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