Rates, Risk Factors, and Progression of Diabetic Retinopathy in Children with Type 1 Diabetes: A 15‐Year Retrospective Study from a Regional Center in New Zealand
Authors' conclusion
In this regional cohort of children with T1D, there was a high rate of low-grade DR overall and at first retinal screen, with an increasing rate until transfer to adult services. Our findings underscore the importance of ongoing DR screening, reducing glycaemic levels, and supporting vulnerable high-risk groups.
Study context
- Population
- Youth with T1D aged <16 years receiving care from a regional diabetes service in New Zealand, January 2006–December 2020; mean age at T1D diagnosis 7.4 ± 3.6 years, 47% female, 69% NZ European
- Participants
- 646 participants
- Outcome
- DR rate at first DR screen (ISPAD guidelines)
- Follow-up
- First DR screen
Methodological detailsregional diabetes service, single-centre
- Regional diabetes service
- Single-centre
Main finding
As reported in the abstract
DR at first screen · first DR screen (mean age 12.6 ± 2.4 years; 5.2 ± 2.2 years after T1D diagnosis)
- Diabetic retinopathy (DR) diagnosed at first screen
- 23.5% (152/646)
- Minimal DR (of DR cases)
- 69.1% (105/152)
- Mild DR (of DR cases)
- 30.3% (46/152)
- Moderate DR
- one moderate case (0.7%)
- Older age at diagnosis predicted DR at first screen
- p=0.029
- Longer diabetes duration predicted DR at first screen
- p=0.015
Observational data: associations, not effects.
Further findings
HbA1c at first screen in patients with ≥1 positive DR screen
- Higher average HbA1c with at least one positive DR screen
- +2.6 mmol/mol; p=0.042
Any positive DR screen overall
- Patients with a positive DR screen
- 55.6% (359/646)
- Worst grade minimal
- 58.2%
- Worst grade mild
- 40.7%
- Worst grade moderate
- three moderate cases (0.8%)
- Worst grade severe
- one severe (0.3%)
DR by age at T1D diagnosis
- T1D diagnosed before age 10 more likely to have DR than older children
- 72% more likely; p < 0.0001
DR by ethnicity
- Higher DR risk in Pacific vs NZ European children
- 32% higher; p=0.008
- Higher DR risk in Pacific vs Māori children
- 41% higher; p=0.014
Predictor of DR at discharge from paediatric services
- Only predictor: HbA1c at first screen
- P < 0.0001
Original publication
Rates, Risk Factors, and Progression of Diabetic Retinopathy in Children with Type 1 Diabetes: A 15‐Year Retrospective Study from a Regional Center in New Zealand. Pediatr Diabetes. Published 28 June 2024. doi:10.
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