Early signs of microvascular complications in pediatric patients with short duration of type 1 diabetes mellitus seen in southeast Nigeria

• Published in: Annals of African medicine 2019-10, Vol.18 (4), p.200-205
• Main Authors: Ogugua, Chinwe, Chikani, Ugo, Ibekwe, Maryann, Ngwieri, Thomas, Allen, Holley
• Format: Article
• Language: English
• Subjects: Adolescent; Age; Albuminuria - epidemiology; Blood Glucose; Blood pressure; Body mass index; Child; Child health; Childhood; Children; Complications and side effects; Creatinine - blood; Cross-Sectional Studies; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - epidemiology; Diabetic Nephropathies - diagnosis; Diabetic Nephropathies - epidemiology; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - epidemiology; Endocrinology; Female; Glycated Hemoglobin A - analysis; Glycated Hemoglobin A - metabolism; Health risk assessment; Hemoglobin; Humans; Kidney diseases; Male; Nigeria - epidemiology; Original; Patients; Pediatrics; Puberty; Risk Factors; Signs; Teachers; Teenagers; Time Factors; Tropicamide; Type 1 diabetes; Urine; Young Adult; Youth
• ISSN: 1596-3519; 0975-5764
• DOI: 10.4103/aam.aam_5_19

Background: Clinically evident microvascular complications are rarely seen among children and adolescents with type 1 diabetes mellitus (T1DM), although early signs develop during childhood and accelerate during puberty. Aim: The aim of this study was to determine the prevalence of early signs of microvascular complications in children and adolescents aged 9-19 years with a short duration of T1DM by screening for retinopathy and nephropathy. Methods: A cross-sectional study and participants were consecutively enrolled from the Endocrinology Clinic at Federal Teaching Hospital, Abakaliki. Physical examination and mydriatic ophthalmoscopy were conducted. Three early morning spot urine specimens for albumin/creatinine ratio were estimated 3 months apart. Serum creatinine levels were estimated, and the glomerular filtration rate was calculated. Glycosylated hemoglobin (HbA1c) was determined. Results: Twenty-four individuals participated, 15 (62.5%) were male and the mean age at diagnosis was 12.4 ± 2.3 years. The mean duration of diabetes was 23.8 ± 20.6 months. The mean HbA1c was 11.4%. Retinopathy was seen in 16.7%, whereas 33.3% had microalbuminuria. Blood pressure range was within the 50th-90th percentile for all the participants. Conclusion: The study outcome demonstrated a high prevalence of early signs of microvascular complications such as retinopathy and nephropathy among youths with short duration of T1DM. Poor glycemic control, if not halted, is associated with early signs of microvascular complications which may become clinically evident; contrary to the belief that they are rare in childhood.