Prevalence and risk factors for diabetic retinopathy in children with type 1 diabetes: an update from a single centre

Bethany Davies; Eman Kamaleldeen; Zainab Mohamed; Chamila Balagamage; Ruchi Nadar; Ruth Krone; Melanie Kershaw; Timothy Barrett; Sam Gurney; Renuka Dias

doi:10.1530/endoabs.111.P37

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Endocrine Abstracts (2025) 111 P37 | DOI: 10.1530/endoabs.111.P37

BSPED2025 Poster Presentations Diabetes 2 (10 abstracts)

Prevalence and risk factors for diabetic retinopathy in children with type 1 diabetes: an update from a single centre

Bethany Davies ¹ , Eman Kamaleldeen ¹ , Zainab Mohamed ¹ , Chamila Balagamage ¹ , Ruchi Nadar ¹ , Ruth Krone ¹ , Melanie Kershaw ¹ , Timothy Barrett ^1,2 , Sam Gurney ¹ & Renuka Dias ^1,2

Author affiliations

¹Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom; ²University of Birmingham, Birmingham, United Kingdom

Introduction: Diabetic retinopathy (DR) is a leading cause of vision loss in the UK and poor glycaemic control (HbA1c) is a key modifiable risk factor. Although sight-threatening retinopathy is rare in childhood, it is well-established that early changes of retinopathy can be seen in children and young people (CYP). From National Paediatric Diabetes Audit longitudinal data, HbA1c has reduced significantly over the last decade, but CYP retinopathy rates have remained relatively static. We demonstrated, in 2008, that the prevalence of background DR was 19.5% with a median HbA1c of 73 mmol/mol (1). This study aimed to explore if DR prevalence had changed and associations with clinical and/or socio-demographic factors.

Methods: Retrospective review of electronic health records of all CYP with Type 1 Diabetes (T1D) eligible for DR screening (>=12 years) between 2022-2024. All values are median unless stated otherwise.

Results: 84 eligible children were offered screening. Of these, 16 (19%) did not attend their offered screening appointment. In those who attended screening, DR was detected in 6/68 (8.9%). All had background retinopathy (R1) with no maculopathy. Table 1 summarises key findings. Patients with DR showed no significant difference in HbA1c (P = 0.1), duration of diabetes (P = 0.8), ethnicity (P = 0.3) or socio-economic status (P = 0.4). Notably, R1 retinopathy does not automatically progress. In both cohorts no DR progression was seen across 2 audit years.

Table 1
	2022-2024			2008-2010 (1)
	Diabetes duration (years, IQR)	HbA1c ( mmol/mol, IQR)		Diabetes duration (years, range)	HbA1c ( mmol/mol, range)
DR (n = 6)	5.3 (1.7-8.9)	68.5 (49-73)	DR (n = 30)	7.7 (0.6-13.7)	76 (55-130)
No DR (n = 62)	3.0 (1.7-5)	56 (39-101)	No DR (n = 119)	5 (0.2-12.5)	70 (38-120)

Conclusions: DR prevalence has reduced by over 50% over 17 years in our centre. Although there appeared to be differences in the DR cohort for HbA1c and duration of diabetes this was not found to be significant, probably due to the small number in the DR group. Further work needs to be done to explore these initial data.

Reference: 1. Dhillon et al (2016). Natural history of retinopathy in children and young people with type 1 diabetes. Eye, 30(7), pp.987–991.