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Infant and toddler type 1 diabetes: complications after 20 years' duration

Silvana Salardi1, Massimo Porta, Giulio Maltoni

  • 1Department of Pediatrics, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. silvana.salardi@unibo.it

Diabetes Care
|February 11, 2012
PubMed

Insights

Early diabetes diagnosis in toddlers may protect against diabetic retinopathy (DR), but poor metabolic control negates this benefit. Pubertal onset increases DR risk, potentially linked to blood pressure.

Area of Science:

  • Endocrinology
  • Ophthalmology
  • Pediatrics

Background:

  • Type 1 diabetes onset timing influences long-term complication risk.
  • Understanding the impact of prepubertal versus pubertal diabetes onset is crucial for managing diabetic complications.

Purpose of the Study:

  • To compare the effect of prepubertal diabetes duration on complication occurrence.
  • To evaluate diabetic retinopathy (DR) and other complications based on diabetes onset during prepuberty versus puberty.

Main Methods:

  • Multicenter study of 105 patients (aged 16-40.3 years) divided into prepubertal (n=53) and pubertal (n=52) onset groups.
  • Assessed retinal photographs, urinary albumin excretion (UAE), blood pressure (BP), and lifetime HbA(1c).

Main Results:

  • Higher prevalence of any-grade DR (71% vs. 40%) and mild-to-severe DR (P=0.005) in pubertal onset patients.
  • No significant difference in abnormal UAE between groups.
  • Elevated lifetime HbA(1c) in prepubertal onset patients with moderate-to-severe DR (P < 0.01).

Conclusions:

  • Long prepubertal diabetes duration may offer protection against DR, especially with good metabolic control.
  • Pubertal onset is associated with higher DR risk, potentially influenced by factors like BP.
  • Metabolic control significantly impacts DR risk, particularly in those with early-onset diabetes.
Abstract

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