Modifiable risk factors linked with DR, DME in pediatric diabetes
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Modifiable risk factors, including high blood pressure and HbA1c, were associated with diabetic retinopathy and diabetic macular edema in pediatric subjects with type 1 diabetes, according to a study.
In her presentation at the virtual Association for Research in Vision and Ophthalmology meeting, Konstantina Sampani, MD, said risk factors for vascular complications, such as DR and DME, are well established in adults with diabetes but have not been fully explored in children.
“Given the steady rise in rates of childhood obesity and diabetes worldwide, and the fact that retinopathy is the most common diabetic vascular complication, it is especially relevant at this time to elucidate the contribution of body mass index in the risk of development of DR,” she said.
Using medical records from 2005 to 2020, researchers conducted a chart review of pediatric subjects to identify factors associated with DR and DME in those with diabetes. They collected demographic information, DR and DME severity, as well as data on blood pressure, BMI and HbA1c.
The analysis comprised 3,454 eyes of 1,735 subjects. Mean subject age was 15.4 years, duration of diabetes was 7.1 years, mean age of diabetes onset was 8.3 years, and mean HbA1c level was 8.4%. DR was present in 8.5% of eyes, and DME was present in 1.3% of eyes.
Sampani and colleagues found that DR was associated with higher HbA1c (P < .0001) and elevated or high blood pressure (P < .0001) but not with higher BMI.
Only elevated HbA1c levels were associated with DME in pediatric subjects with diabetes (P = .002). However, the association did not remain significant in a multivariate analysis.
“Efforts to optimize these factors in youth from an early age may help reduce subsequent adverse ocular outcomes,” Sampani said. “Further prospective, longitudinal studies can assess if early intervention to improve factors other than glycemic control, such as weight or blood pressure, can reduce the occurrence of diabetic retinopathy and diabetic macular edema in youth with type 1 diabetes.”
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Sampani K, et al. Modifiable risk factors for diabetic retinopathy (DR) and macular edema (DME) in children with type 1 diabetes (T1D). Presented at: Association for Research in Vision and Ophthalmology annual meeting; May 1-7, 2021 (virtual meeting).
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