Endocrine Abstracts

Background: Glycaemic control and duration of diabetes mellitus play an important role in delaying or preventing diabetic retinopathy. NICE guidelines state that for type 1 diabetes, those aged 12 years and over must be offered annual retinopathy screening. This audit aims to assess compliance with the guidelines and the prevalence of retinopathy.

Methods: This was a retrospective audit of paediatric diabetic patients registered to Good Hope Hospital attending diabetic retinopathy screening in 2011 and 2012. Data was obtained from the Retinal screening co-ordinators and the Optimize database. All children aged 12 at the start of the year of screening with type 1 or type 2 diabetes were included. Data collected included: demographic factors, screening attendance and results; HbA1c levels, and durations of diabetes.

Results: In 2011, of 79 eligible paediatric patients, 49 (62%) attended their annual retinopathy screening. 10 (20.4%) of patients had stage 1 retinopathy. Patients with retinopathy had a higher mean HbA1c (9.6 mol/l vs 9.3 mmol/l) and a longer duration of diabetes (8.6 years vs 5.8 years, P value <0.05).

In 2012, of 91 eligible paediatric patients, 63 (69.2%) attended their annual retinopathy screening. 14 (22.2%) of patients had stage 1 retinopathy. Patients with retinopathy had a higher mean HbA1c (9.9 mol/l vs 9.5 mmol/l) and a longer duration of diabetes (7.9 years vs 5.5 years, P value <0.05).

Conclusion: Glycaemic control varies widely within this cohort, but on average is higher than the recommended target level in paediatric patients both with and without retinopathy. Longer duration of diabetes is significantly associated with retinopathy. Retinal screening uptake in the community needs to be improved by patient education and better communication with primary care. The suboptimal glycaemic control may be improved by the use of intense insulin regimens and structured education programmes.