Diabetes in children is a real challenge today, as the prevalence of the disease continues to rise globally. According to the U.S. National Library of Medicine (NLM), the number of children with diabetes increased by 39.37% from 1990 to 2019. The annual increase in individuals with diabetes is almost 1.4% [1]. It is noteworthy that there is a constant rise in the incidence of type 2 diabetes in the pediatric population, a condition that was once considered exclusive to adults several decades ago.
One of the potential severe complications of diabetes is diabetic retinopathy (DR), which poses a threat to children as well. Medical statistics indicate that the risk of developing DR in children arises within five years of diagnosis and increases with the duration of the disease [2].
Therefore, it is not surprising that one of the most structured healthcare systems, the British NHS, officially recommends screening for DR not only for adults but also for children [3].
According to NHS recommendations, children aged 12 with diabetes should undergo eye screening at least twice. If signs of retinal damage are not detected immediately after the diagnosis of diabetes, the subsequent screening schedule is established as annual or every two years [4].
Currently, in Ukraine, DR screening is not implemented at the national level, even for adults. However, we have received general recommendations from the Ministry of Health of Ukraine regarding screening for children with diabetes.
In Ukraine, for individuals with diabetes with a duration of less than ten years and mild eye problems, ophthalmic examinations should be conducted every two years. If the risk of vision loss is high, more frequent examinations are recommended. If the eye condition worsens with unstable blood sugar control, tests should be conducted every three months during treatment. It is also vital to check eyes for other conditions, such as cataracts and other anomalies [5].
Pediatric endocrinologist Dr. Larisa suggests that screening for children should start as early as 11 years old:
For young patients with type 1 diabetes with a duration of 2-5 years, screening is recommended to start at 11 years old and be repeated every 2-3 years. For children diagnosed with type 2 diabetes, reliance on the results of the last screening is advised. In case of sudden deterioration of vision, it is essential to consult an ophthalmologist specializing in diabetes.
The Ministry of Health’s recommendations on screening are already a significant step in developing healthcare in Ukraine. However, the CheckEye team is working to make one of the most practical, economically efficient, and demanded tools today a part of the daily practice of Ukrainian doctors and patients with diabetes. We particularly emphasize the importance of caring for children, believing that the next step after implementing national DR screening for adults will be a screening program for children with diabetes.
Sources:
- Zhang K et al. (2023). Global, regional, and National Epidemiology of Diabetes in children from 1990 to 2019. JAMA pediatrics. https://pubmed.ncbi.nlm.nih.gov/37399036/#:~:text=In%202019%2C%20there%20were%20227,UI%2C%204450%2D6507).
- Crist, C. (2023, March 23). Retinopathy “Emerging Decades Earlier” in Kids With Type 2 Diabetes Than in Adults. Medscape. https://www.medscape.com/viewarticle/990052?form=fpf
- NHS. (n.d.). Diabetic retinopathy. NHS choices.
https://www.nhs.uk/conditions/diabetic-retinopathy/#:~:text=next%20screening%20appointment.-,Diabetic%20eye%20screening,be%20invited%20every%202%20years. - Your guide to diabetic eye screening. GOV.UK. (n.d.).
https://www.gov.uk/government/publications/diabetic-eye-screening-description-in-brief/your-guide-to-diabetic-eye-screening - Стандарти медичної допомоги. Цукровий діабет у дітей. Міністерство охорони здоров’я України. (2023, February 28).
https://www.dec.gov.ua/wp-content/uploads/2023/02/413_28022023_dod.pdf