Early Diagnosis of So‐Called Late Complications in Type 1 Diabetic Children

Abstract

AbstractPrevention of late complications is the main problem in type 1 diabetes of childhood. Longitudinal studies of subjects diagnosed before puberty demonstrated significant prevalence of retinopathy, nephropathy and neuropathy after 10‐ 15 years, correlated with the duration of diabetes. Proliferative retinopathy is rarely observed in children with diabetes of less than 5 years duration but vitreous fluorophotometry has shown abnormalities of retinal vessels in asymptomatic patients. In early diabetes glomerular permeability can be tested by radioimmunoassay of microalbuminuria; values above 30 mcg/min are a good predictor of later clinical proteinuria. The development of overt neuropathy is extremely variable and it may not be present even after many years of poorly controlled diabetes.Vitreous fluorophotometric abnormalities, basal and post‐exercise microalbuminuria and reduction of nerve conduction velocity have been proven to be reversible with intensive therapy. When secalled “late” complications are diagnosed early, careful and intensive therapy to maintain metabolic equilibrium near normal is called for.