It s well known that poorly controlled and long-lasting diabetes can lead to changes in the retina (retinopathy), and is a leading cause of blindness. Alarmingly, a recent study described in Med Page Today found that even young people with type 2 diabetes might have retinal changes within only five years of the onset of the disease.
In a preliminary report, Dr. LL Levitsky and colleagues at the Massachusetts General Hospital in Boston described the results of their study of diabetic kids initially aged 10 to 17 years. They discovered that within five years of the onset of the disease, nearly 14 percent had some evidence of retinopathy.
The evidence came from digital photographs of the retinas of 571 young participants their average age at the time of the exam was 18 years. A diagnosis of retinopathy was made if there were retinal lesions in at least one eye.
Two-thirds of the patients were girls, and all were overweight or obese with an average BMI of 36 (a BMI of 30 or more is considered obese).
A significant factor associated with an increased risk of retinopathy was the extent of blood sugar control, which was estimated by levels of glycated hemoglobin, or HbA1c. Approximately five percent of those with the lowest levels (best control) of HbA1c had indications of retinopathy, while those with the poorest control had a prevalence of retinopathy of 25 percent.
Although most of the study participants were obese, the degree of obesity did not seem related to the likelihood of retinopathy. Dr. Levitsky commented This is known as the obesity paradox, and has been observed in adult retinopathy as well.
However, the prevalence of retinopathy was related to the age of the patient: For those between 12 and 16, it was 5.7 percent, increased to 12.4 percent in 17 and 18 year-olds, and to 19 percent for those who were between 19 and 24 years old.
ACSH s Dr. Gilbert Ross noted, This study, although preliminary, underscores the importance of reaching out to young people and emphasizing the serious risks associated with obesity-linked type 2 diabetes. Diabetic retinopathy is a condition that one should try to avoid at all costs.
