The significance of the prepubertal diabetes duration for the development of retinopathy and nephropathy in patients with type 1 diabetes

• Published in: Journal of diabetes and its complications 2004-05, Vol.18 (3), p.160-164
• Main Authors: Olsen, Birthe S., Sjølie, Anne Katrin, Hougaard, Philip, Johannesen, Jesper, Marinelli, Karin, Jacobsen, Bent Brock, Mortensen, Henrik B.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adult; Age of Onset; Albuminuria - complications; Albuminuria - physiopathology; Blood pressure; Child; Children & youth; Cohort Studies; Confidence intervals; Denmark - epidemiology; Diabetes; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - physiopathology; Diabetic Nephropathies - complications; Diabetic Nephropathies - epidemiology; Diabetic nephropathy; Diabetic retinopathy; Diabetic Retinopathy - complications; Diabetic Retinopathy - epidemiology; Disease Progression; Female; Follow-Up Studies; Forecasting; Glycated Hemoglobin A - adverse effects; Glycated Hemoglobin A - chemistry; Glycosylated haemoglobin; Humans; Male; Pediatrics; Pre-pubertal diabetes duration; Prospective Studies; Puberty - physiology; Studies; Teenagers; Time Factors; Type 1 diabetes
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/S1056-8727(03)00073-4

Objective: A Danish nationwide prospective cohort of children and adolescents with type 1 diabetes was followed for 8 years to study the effect of the prepubertal duration of diabetes on early retinopathy and elevated albumin excretion rate (AER) (>20 μg/min). Research Design and Methods: In 1989, blood glucose control (HbA1c) and AER was investigated in approximately 80% of all Danish children and adolescents with type 1 diabetes. A cohort of 339 young patients were restudied in 1995 including physical examination, demographic data, HbA1c, AER, and fundus photography with central reading. Among the patients, a number of 304 had a prepubertal onset of diabetes defined as an onset age less than 11.7 years in girls and 12.9 years in boys. Microalbuminuria was defined as an AER of 20–150 μg min−1 and macroalbuminuria as AER >150 μg min−1 in two out of three timed overnight urine samples. Results: At the follow-up in 1995–1996, no patients were younger than 12 years of age. The prevalence of any level of retinopathy was 17.7% in the age group 12–15 years, 45.4% from 16 to 20 years, and increased to 67.6% in patients more than 20 years of age. Diabetic retinopathy was significantly associated to poor long-term metabolic control (HbA1c) (P