Related Experiment Video
Updated: Feb 28, 2026
Retinal Pigment Epithelium Transplantation in a Non-human Primate Model for Degenerative Retinal Diseases
Published on: June 14, 2021
Short-term poor glycemic control and retinal microvascular changes in pediatric Type 1 Diabetes patients in
Ling-Jun Li1,2, Ecosse Lamoureux3,4, Tien Yin Wong3,4
1Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. queenie.li.l.j@seri.com.sg.
Insights
Poor glycemic control in children with Type 1 Diabetes (T1D) can lead to early changes in retinal microvasculature. This pilot study found wider retinal arterioles and larger branching angles in T1D patients with high HbA1c levels after one year.
Area of Science:
- Ophthalmology
- Endocrinology
- Pediatrics
Background:
- Poor glycemic control in Type 1 Diabetes (T1D) is linked to microvascular complications.
- The impact of short-term poor glycemic control on microvascular changes in children with T1D is not well understood.
- This study investigates early microvascular changes in pediatric T1D patients.
Purpose of the Study:
- To examine the longitudinal association between glycemic control and retinal microvasculature changes in pediatric T1D patients.
- To determine if poor glycemic control over one year causes detectable morphological changes in retinal vessels.
- To provide insights into the early stages of diabetic microvascular complications.
Main Methods:
- A retrospective, longitudinal study of 55 pediatric T1D patients in Singapore.
- Patients were divided into two groups based on glycemic control: poor (HbA1c ≥8%) and good (HbA1c <8%).
- Retinal photography and quantitative analysis of vascular parameters (caliber, branching angle) using SIVA software after one year.
Main Results:
- No significant differences in ethnicity, T1D duration, blood pressure, BMI, or LDL between groups.
- Patients with poor glycemic control showed a trend towards wider retinal arteriolar caliber.
- Significantly larger retinal arteriolar branching angles were observed in the poor glycemic control group compared to the good control group.
Conclusions:
- One year of poor glycemic control in pediatric T1D patients is associated with abnormal retinal microvascular morphology.
- These early morphological changes may precede pathological manifestations and indicate future risk.
- Findings highlight the importance of maintaining good glycemic control in children with T1D to prevent long-term complications.
Background:
Poor glycemic control in Type 1 Diabetes (T1D) patients is strongly associated with an increased risk of diabetes-related microvascular complications later in life, but it is unclear whether short period of poor glycemic control in children with T1D can cause evident microvascular morphological changes long before any pathological manifestation. Our study aimed to investigate the longitudinal association between poor glycemic control and subsequent changes in retinal microvasculature, in a pilot study of 55 pediatric T1D patients from Singapore after a one-year follow-up.
Methods:
This is a hospital-based, exposure-matched and retrospective longitudinal study. A total of 55 T1D patients were included from Singapore KK Women's and Children Hospital, 28 of whom had poor glycemic control (average glycated hemoglobin [HbA1c] ≥8% during the year) while the other 27 age- and gender-matched subjects had good glycemic control (HbA1c <8%). Retinal photography was taken at diabetes annual screening and images were graded by trained graders using a semi-automated computer-based program (Singapore I Vessel Assessment [SIVA], version 4.0, Singapore Eye Research Institute, Singapore) and a spectrum of retinal vascular parameters (e.g. caliber, tortuosity, branching angle and fractal dimension) were measured quantitatively from 0.5 to 2.0 disc diameters.
Results:
There was no significant difference in ethnicity, duration of T1D, blood pressure, body mass index (BMI) and low-density cholesterol lipoprotein (LDL) between the two groups. Retinal imaging was obtained at the end of 1 year of glycemic control assessment. In multiple linear regression adjusting for ethnicity, BMI, LDL and duration of T1D, patients with poor glycemic control tended to have marginally wider retinal arteriolar caliber (6.0 μm, 95% CI: -0.9, 12.8) and had significantly larger retinal arteriolar branching angle (10.1 degrees, 95% CI: 1.4, 18.9) compared with their age- and gender- matched counterparts with good glycemic control.
Conclusions:
Our findings showed that abnormal retinal microvascular morphology was evident in pediatric patients with T1D after one-year's poor glycemic control. Such morphological abnormalities may lead to future development of microvascular complications among T1D pediatric patients with poor glycemic control.
