Docs and diabetic kids need to stick to guidelines

Eye exams and tests of long-term blood sugar control are routine methods of managing diabetes: hemoglobin A1C tests offer a picture of a diabetic person s blood sugar levels over the course of several months, while regular eye exams can spot and allow for early treatment of the damaged retinal blood vessels associated with diabetes. However, a study just published in the journal Pediatrics has found that a significant number of children and young adults with diabetes are not getting these recommended tests.

Researchers found that about one third of the more than 1,500 diabetic young people surveyed were neglecting the tests. The American Diabetes Association recommends that the eye exam should be done once a year, while the A1C should be measured at least twice a year.

Lead author Dr. Beth Waitzfelder, an investigator at the Kaiser Permanente Center for Health Research in Honolulu, suggested several explanations for why so many patients are skipping these tests. She cited the possibility that younger patients are simply less vigilant about their diabetes, and also noted that a change from pediatrician to general practitioner could disrupt routine. The study also found that children from low-income families were less likely to have these tests done, as were children who saw generalists instead of doctors whose specialty includes diabetes care.

These are simple tests to do, says ACSH's Dr. Gilbert Ross. Young patients may neglect them because the real damage isn t likely to develop until they re older, but getting these routine tests on schedule will help prevent major complications later on.