Study Says Eye Screening for Children with Type 1 Diabetes Should Start Later
Research suggests exams could be delayed until age 15 or 5 years after diagnosis
A new study has found that advanced forms of a diabetic eye disease are rare among children living with diabetes. Due to this, researchers of the study are recommending that most children with type 1 diabetes delay annual diabetic retinopathy screenings until age 15 or 5 years after their diabetes diagnosis, whichever occurs later.
It is well known that early detection and timely treatment of diabetic retinopathy reduces vision loss in adults. This has prompted some physician organizations to recommend screening children for this disease annually starting at an early age – after age 9, or from 3 to 5 years after their diagnosis.
However, researchers have questioned these guidelines, concerned that the annual exams may create excessive financial and logistical burdens for families and the health care system. The researchers conducted a study of the records of 370 children under age 18 with type 1 and type 2 diabetes. All had received at least one diabetic retinopathy screening exam between 2009 and 2013, but none were found to have the condition.
The researchers then examined the data that led to the current screening guidelines. They found that between 0 and 28 percent of the children studied had diabetic retinopathy, but the majority of cases were very mild and thus would not be ready for treatment. They also found that the youngest person reported to have severe diabetic retinopathy was between 15 and 19 years old, and 5 to 6 years was the shortest time period of having diabetes before developing severe diabetic retinopathy.
With this in mind, the researchers suggest that screenings for children with type 1 diabetes could begin at a later age than previously recommended. They also say exceptions should be made for children with type 2 diabetes and those identified by their endocrinologists as having high risk for diabetic complications. Those at high risk may require more frequent or earlier eye exams.
The American Academy of Ophthalmology currently recommends that people with type 1 diabetes have annual screenings for diabetic retinopathy beginning 5 years after the onset of their disease, and that those with type 2 diabetes should have an examination at the time of diagnosis and at least once a year thereafter.