African-American kids with T2D and risk for retinopathy are less likely to receive eye exam

Jul 2 2013

In one of the few studies to provide information on eye screening of children, African-American children with the greatest risk for disease of the retina as a complication of Type 1 diabetes are the least likely to have received an eye exam, reports a team of researchers including senior author Terri H. Lipman of the University of Pennsylvania School of Nursing.

"Only 64% of eligible children were screen for retinopathy [inflammation of the retina that can lead to blindness] in the 24 months studied despite recommendations for yearly exams to all families," the authors write in the current edition of Diabetes Research and Clinical Practice. "Children who were not screened were significantly more likely to be black or have poorer diabetes control."

While 66 percent of white children were screened, only 54 percent of black children received appropriate screenings. The researchers found that the screenings—or lack of them—were not related to whether the children had private or public health insurance.

"This study shows that our children who are at highest risk are not receiving the help they need," said Dr. Lipman, CRNP, FAAN, the Miriam Stirl Endowed Term Professor of Nutrition and Professor of Nursing of Children. "We need to ensure that all children have access to adequate healthcare."

Children are also showing signs of eye disease from Type 2 diabetes.

Another study of retinopathy in children with diabetes was also co-authored by Dr. Lipman. In the TODAY study, a multicenter study funded by the National Institutes of Health, children with Type 2 diabetes were also found to be at risk for retinopathy, or damage to the eye's retina affecting sight. Nearly 14 percent of young people who had diabetes for about five years showed signs of retinopathy. Of 517 children, 71 had early signs of retinopathy. The study did not find racial differences.

The research, published in the current edition of Diabetes Care, and also authored by Dr. Lipman, studied 699 children between 10 and 17 who were on a combination of medicines including metformin, metformin plus rosiglitazone, or metformin plus lifestyle changes and were followed for 2 to 6 and-a-half years.

All of the participants were overweight or obese.

"These studies bring to light the importance of screening for eye disease in all children with diabetes" said Dr. Lipman who also holds an appointment at The Children's Hospital of Philadelphia, a site for both studies of retinopathy in youth.

Source: The University of Pennsylvania School of Nursing