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Diabetic angiopathy in children
T Danne1, O Kordonouri, G Hövener
1Kliniken und Polikliniken für Kinderheilkunde und Kinderchirurgie, Charité-Virchow-Klinikum, Med. Fakultät Humboldt Universität zu Berlin, Germany.
Diabetic Medicine : a Journal of the British Diabetic Association
|February 10, 1998
Summary
Diabetic retinopathy and nephropathy are key concerns in children. Early detection via regular eye exams and urine tests, alongside managing blood sugar and pressure, is vital for preventing long-term complications.
Area of Science:
- Pediatric Endocrinology
- Diabetology
- Ophthalmology
Background:
- Diabetic retinopathy and nephropathy are significant secondary complications in children with diabetes.
- Regular monitoring of retinal status and urinary albumin excretion is crucial, especially after puberty or 5 years of diabetes.
Purpose of the Study:
- To highlight the importance of early detection and management of diabetic complications in pediatric patients.
- To discuss risk factors and treatment strategies for retinopathy and nephropathy in children with diabetes.
Main Methods:
- Analysis of diabetes duration and diagnostic methods (fluorescein angiography vs. ophthalmoscopy) for retinopathy.
- Assessment of microalbuminuria prevalence and associated risk factors in pediatric populations.
- Review of treatment benefits, including antihypertensive drugs, and challenges in managing microalbuminuria.
Main Results:
- Retinopathy detected by fluorescein angiography appears after a median of 9 years, versus 14 years by ophthalmoscopy.
- 10-20% of children may develop microalbuminuria starting in puberty.
- Glycemic control is a primary risk factor, with blood pressure, lipids, and genetics also contributing.
Conclusions:
- Early detection of diabetic retinopathy and nephropathy in children is essential.
- Comprehensive management including glycemic control, blood pressure monitoring, and timely intervention is critical for improving long-term outcomes.
- Further research is needed to clarify the prognostic relevance of intermittent microalbuminuria in pediatric patients.