Prevalence of diabetic retinopathy in children and adolescents with type-1 diabetes attending summer camps in France

Objective. - To evaluate, using fundus photography, the prevalence of diabetic retinopathy (DR) in young diabetic subjects attending summer camps run by the Aide aux Jeunes Diabetiques Association (Aid to Young Diabetics). Research design and methods. - Five hundred and four children and adolescents (250 boys and 254 girls), with type 1 diabetes mellitus, aged 10-18 years (mean: 13 +/- 2), were screened for DR using non mydriatic photography, during their stay in a holiday camp. Demographic and clinical data recorded on subjects' arrival in the camp included date of birth, height, weight, treatment, blood pressure, and duration of diabetes. HbA(1c) was determined with a DCA 2000 kit. Results. - Mean diabetes duration was 4.8 +/- 3.4 years and mean HbA(1c) was 8.5 +/- 1.3%. Mild non proliferative DR was diagnosed in 23 children (4.6%). Compared to subjects without DR, those with DR were significantly older (P < 10(-3)), had a longer duration of diabetes (P = 0.001), higher systolic blood pressure (P = 0.04), and had higher (but not significantly so) HbA(1c) (P = 0.15). After adjustment for age, only longer duration remained significantly associated with DR (P = 0.01). Conclusion. - The prevalence of DR in these young patients was low compared to that reported in previous studies. The decrease may be due to modem diabetes care with multiple insulin injections. However, early detection of DR in adolescents, especially in their late teens, remains important, because it allows the identification of patients at high risk of progression towards severe stages of DR. (C) 2007 Elsevier Masson SAS. All rights reserved.