This article is more than 5 years old. Information may no longer be current.
Blood pressure may predict retinopathy in adolescent type 1 diabetes
Click Here to Manage Email Alerts
Adolescents with type 1 diabetes and systolic or diastolic blood pressure on or above the 90th percentile may be at an increased risk for retinopathy.
According to recent data from researchers at Children’s Hospital at Westmead, the University of Sydney and the University of New South Wales in Australia, age, duration of diabetes, HbA1c, height and log albumin excretion rate may also be predictors of retinopathy.
The prospective cohort study included 1,869 patients with type 1 diabetes. The median age at baseline was 13.4 years. The researchers screened patients for diabetes complications and measured systolic and diastolic BP.
During follow-up, 673 patients developed retinopathy. Baseline age, rate of albumin excretion and prevalence of microalbuminuria did not differ between patients who developed retinopathy and those who did not. However, systolic and diastolic BP, duration of diabetes and HbA1c levels were higher in those who developed retinopathy.
Patients with an albumin excretion rate <7.5 mcg/minute (n=1,025) had a higher cumulative risk for retinopathy at 10 years’ duration of diabetes if their systolic BP was on or above the 90th percentile (58%), compared with those below the 90th percentile (35%; P=.03).
Similar results were found for those with diastolic BP on or above the 90th percentile (57%), compared with those below the 90th percentile (35%; P=.005). – by Stacey L. Adams
BMJ. 2008;337:a918.
Health doesn’t begin when you become an adult, it beings in youth. These kids are not only facing a disease that can be rather unruly in terms of health outcomes, but diabetes can also increase the likelihood of increased BP problems, not the least of which could be related to weight gain. So, the real critical thing here is for kids with diabetes and their parents along with their physician — it’s a team effort here — to help provide and plan for the best possible healthy lifestyle they can to minimize the onset of any of these complications. In kids, high BP isn’t that common, but as they get older BP tends to go up, and for all diabetics, when they start having elevated BP problems, that creates a huge problem with small vessels like the kidneys, the eyes, etc and larger vessels like the heart, brain, etc. So you really get a lot of vascular problems that, unfortunately, erupt essentially in those unfortunate conditions that are associated with diabetes that render life less quality.
It’s kind of on the edge, in terms of what the researchers came up with, with regards to always having an eye on BP because the eye will ultimately be affected by both systolic and diastolic BP. It is intriguing that they really only looked at very straight forward, clinical measures rather than lifestyle measures. Looking at lifestyle measures could have brought forward a lot of these issues or problems, so that becomes another level of reiteration of this type of study where they look not only at data with HbA1c, but also at dietary patterns, intake patterns and activity patterns.
– Larry S. Verity, PhD, FACM
Professor of Exercise Physiology
Department of
Exercise and Nutritional Sciences
San Diego State University