Yearly eye exams not needed for all diabetic kids

Diabetes can lead to retina damage, and an annual eye exam is currently recommended for children and adolescents with type 1 diabetes. However, an Australian team suggests that screenings at least two years apart are safe in most cases.

Dr. Ann Maguire, from The Children's Hospital at Westmead in Sydney, and colleagues followed more than 1000 young people with diabetes to assess the natural history of retinal disease to help determine appropriate screening intervals.

The subjects were divided into two age groups based on whether they were younger or older than 11 years of age.

In addition, they subjects were classified as higher risk if diabetes duration was longer than 10 years or if their blood sugar levels were not well controlled, the researchers report in the medical journal Diabetes Care.

No significant change in retinal scans was noted after one year in either of the age groups or in the higher risk group, the investigators note. After two years, retinal damage worsened significantly in the older age group, but it took six years before a change was seen in the younger group.

A similar pattern was seen in relation to blood sugar control; retinal damage increased after two years in those with poor control, but not until three years in the group with consistently good control.

The findings suggest that retina screening at two-year intervals is suitable for adolescents with diabetes, and longer intervals appear safe for younger children. However, more frequent screening does seem to be necessary for young people with long-standing or poorly controlled disease, the team advises.

SOURCE: Diabetes Care, March 2005.