Frequency and Risk Factors of Diabetic Retinopathy in Children having Type-1 Diabetes Mellitus

Abstract: Background: Diabetic retinopathy is the most prevalent complication and the primary cause of blindness in people with type 1 diabetes mellitus. There are two categories of risk factors: modifiable and non-modifiable for development of diabetic retinopathy. Objective: To determine the frequency and risk factors of diabetic retinopathy in children having type-1 diabetes mellitus. Materials and Methods: Children aged 7 to 18 years participated in this cross-sectional study, which was carried out in the National Institute of Child Health’s endocrinology department. Clinical, anthropometric, and demographic data of the patients were gathered. To identify diabetic retinopathy, a fundus examination involved examining the optic disc, macula, retinal blood vessels, background, and fundus periphery. Result: With an average age of 14.07±2.82 years, 157 patients were examined. 88(56.1%) were male and 69(43.9%) were female. Average HbA1C level was 10.10±2.63%. Total 116(73.9%) patients had diabetic retinopathy, of which 103(88.8%) had mild non-proliferative, 10(8.6%) had moderate non-proliferative, 1(0.9%) had severe non-proliferative, and 2(1.7%) had proliferative diabetic retinopathy. Diabetic retinopathy was significantly associated with age group (p=0.025), random blood sugar (p=0.050) and insulin regimen type (p=0.018). Male patients had a lower risk of diabetic retinopathy (OR=-0.497, p=0.069). Individuals with age 14 years or less had a lower probability of developing diabetic retinopathy (OR=0.437, p=0.027). Patients with High HbA1c had more risk to develop diabetic retinopathy (OR=1.314, p=0.003). Patients on basal bolus insulin had a higher risk of developing diabetic retinopathy (OR=2.378, p=0.020). Conclusion: The results of our investigation showed that a significant portion of the study group had diabetic retinopathy. The most common kind of retinopathy was mild non-proliferative. Males who were less than 14 years old, had a low HbA1c, had the disease for less than ten years, and used regular insulin and neutral protamine Hagedorn (NPH) were less likely to develop diabetic retinopathy.