Money spent on screening young people with type 1 diabetes for diabetic retinopathy could be better spent elsewhere, according to new US research.
In the UK, guidelines state that everyone with type 1 diabetes aged 12 and older should attend an annual diabetic eye screening, which involves an examination of the back of the eye and photographs of the retina.
In this new review of data taken from the Type 1 Diabetes Exchange Clinic Registry, University of Florida researchers suggest that diabetic retinopathy is “extremely rare” in children, and believe the screening process may not be needed so early on in children’s lives.
The study team surveyed 12,535 patients from the registry, all of whom were under 21 years of age; had been diagnosed with type 1 diabetes for five years; and had HbA1c levels of 8.6 per cent.
The parents of the children were asked whether their child had ever received treatment for diabetic retinopathy, such as with laser injections into or around the eye, or vitrectomy surgery.
Just 45 respondents reported having received retinopathy treatment, but when medical reports were checked, none had actually ever received treatment for diabetic retinopathy.
The document, which was published in the journal Diabetes Care, was written and led by pediatric endocrinologist Dr Giovanna Beauchamp, from the University of Florida.
Dr Beauchamp wrote: “Thus, treated [diabetic retinopathy] is extremely rare in children enrolled in the T1D Exchange Clinic Registry.
“Future studies may indicate that [diabetic retinopathy] screening guidelines can be improved via inclusion of other risk factors such history of glycemic control, presence of microalbuminuria, hypertensio, and dyslipidemia.”
The report concluded that due to the cost of eye examination, the current guidelines – in the US, children with type 1 diabetes are recommended to receive annual eye checks at the age of 10, or when they start puberty – may not be fully justifiable and cost effective for such a low-risk group.
In the document Dr Beauchamp suggested the money could possibly be redirected into other areas to help support the young age group with their diabetes, such as mental health counselling and dietary advice.

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