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Diabetes in children: statistics of complications DIABETES IN CHILDREN: STATISTICS OF COMPLICATIONS
Eye complications (retinopathy)
The sensitive part of the eye that is responsible for vision is situated at the back of the eyeball and called the retina. The retina is composed of special nerve cells and these are supplied with blood by small arteries. In diabetes after many years, these arteries can become weakened and may leak blood or burst, giving small hemorrhages. Later on, scarring can take place and new blood vessels may develop and grow over the nerve cells, putting vision at risk.
The stage of mild blood vessel changes with small hemorrhages is called 'background retinopathy' and does not normally affect vision. It is said to develop in 60% of people after 15 years with diabetes and 90% of people after 30 years. These figures, which are based on adult observations, refer particularly to years after puberty. The early childhood years do not seem to count in calculating the duration of diabetes leading to complications. Perhaps the hormones that develop during adolescence and continue into adult life influence the development of complications.
These early changes may progress to more severe changes in some people with a risk of visual impairment. It is reported that after 15 years of diabetes, 5% of people with diabetes have developed this worsening of retinopathy and after 30 years, 8% have loss of vision.
The early signs of retinopathy can be detected during regular eye checks and if there are signs of deterioration or new vessel formation which would threaten vision, laser treatment (photocoagulation) can prevent further deterioration and preserve vision. Thus regular eye checks are important for a person with diabetes after the early teenage years.
Kidney complications
Within the kidney, the blood is filtered to remove waste products which are excreted by the body as urine. This process of filtering takes place in fine structures called glomeruli, and in diabetes the glomeruli can be affected, either through the small blood vessels within the glomeruli or by changes in the structure of the glomeruli themselves.
Up to 50% of people may show signs of kidney involvement and some may eventually go on to show signs of kidney failure. At that time, a renal transplant may be necessary.
Early signs of kidney involvement can be found by checking the urine for traces of the protein albumin. Albumin is a natural constituent of blood and if there is an alteration in the kidney due to diabetes, some of this albumin may leak out into the urine. There are other causes why albumin may appear in the urine apart from diabetes. In childhood, some of these are of no importance but all need to be checked out.
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