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High rates of ocular complications in a cohort of Haitian children and adolescents with diabetes
Author(s) -
Robinson MarieÈve,
Altenor Ketly,
Carpenter Christopher,
Bonnell Ric,
JeanBaptiste Eddy,
von Oettingen Julia
Publication year - 2018
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12688
Subject(s) - medicine , cataracts , diabetes mellitus , cohort , pediatrics , complication , retrospective cohort study , family history , retinopathy , diabetic retinopathy , body mass index , ophthalmology , endocrinology
Background Ophthalmic complications of pediatric diabetes are rare, and rates are unknown in Haitian youth. Objectives To determine the prevalence and predictors of diabetic retinopathy (DR) and cataracts in a cohort of Haitian youth with insulin‐treated diabetes. Methods We performed a cross‐sectional retrospective review of pediatric patients with diabetes from a pediatric chronic disease center in Haiti, from December 1, 2012 to November 1, 2016. Data collection included demographic and anthropometric information, total daily insulin dose and result of eye examination by a local ophthalmologist. Results Of 67 patients (54% female, mean age at diagnosis 14.6 ± 3.9 years, mean diabetes duration 3.3 ± 3.0 years, mean HbA1c 84 ± 22 mmol/mol (9.8% ± 2.0%), mean current insulin requirement 0.49 ± 0.28 IU/kg/day), DR was diagnosed in 10/57 (18%) and cataracts in 10/62 (16%), at a mean age of 19.0 ± 4.3 and 19.1 ± 3.3 years, respectively. Diabetes duration was 4.9 ± 5.4 and 3.0 ± 1.5 years at the time of diagnosis of DR and cataracts, respectively. Age at complication, insulin requirement, sex, body mass index, family history, mean HbA1c and diabetes duration were not significant predictors of an ocular complication. Conclusions In this cohort of Haitian youth, DR and cataracts occur prematurely. Low‐insulin requirements years after diagnosis, possibly allowing for prolonged undetected hyperglycemia prediagnosis, may explain complication risk. The phenotypes of diabetes in pediatric populations of African ancestry may be distinct. Ophthalmologic evaluation should possibly start at diagnosis, and screening guidelines may need to be adapted.