Diabetic retinopathy (eye disease) is common among children with type 2 diabetes worldwide, with more than 25% of children with long-term type 2 diabetes experiencing this complication, according to a new analysis published in the journal JAMA Network Open.
There is evidence that vision impairment is on the rise among people with diabetes, and rates of diabetic retinopathy are expected to rise worldwide in coming years. While high blood glucose is believed to be the main culprit behind diabetes-related eye problems, there is also evidence that hypoglycemia (low blood glucose) may worsen eye disease. It’s not a given that diabetes-related eye problems will lead to major vision loss — by getting regular eye exams as recommended, you may be able to treat problems early on and prevent or slow vision loss. There is also evidence that drinking coffee and taking aspirin or other anticoagulants may reduce your risk for retinopathy, and undergoing bariatric surgery may also reduce this risk in people with type 2 diabetes and obesity.
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Significant portion of children with type 2 diabetes worldwide found to have retinopathy
For the latest analysis, researchers examined 27 previously published observational studies that included a total of 5,924 children with type 2 diabetes. They were interested in looking at the overall prevalence of diabetic retinopathy in these children, as well as how factors like diabetes duration, race, sex, age, and obesity affected the likelihood of having retinopathy. Overall, the researchers found that 6.99% of children with type 2 diabetes had retinopathy, based on the results seen in screening programs around the world. Not surprisingly, having diabetes for a longer duration was linked to a higher rate of retinopathy. For children who were diagnosed with type 2 diabetes less than 2.5 years earlier, the rate of retinopathy was 1.11%. For those with diabetes between 2.5 and five years, the rate of retinopathy was 9.04%. And for children with diabetes for longer than five years, the rate of retinopathy was 28.14%.
The rate of retinopathy increased with age among children with type 2 diabetes, which may reflect a longer diabetes duration rather than an inherently higher risk at older ages. There was no overall link seen between sex, race, or obesity and the risk of developing retinopathy in children with type 2 diabetes.
Based on the nine studies that reported the severity of diabetic retinopathy among participants, the rate of minimal to moderate nonproliferative (less serious) diabetic retinopathy was 11.16%, the rate of severe nonproliferative diabetic retinopathy was 2.57%, and the rate of proliferative (most serious) diabetic retinopathy was 2.43% among children with type 2 diabetes. The rate of macular edema — a type of swelling in the eye that can result from serious retinopathy — was 3.09%.
“While the current pediatric [type 2 diabetes] clinical practice guidelines recommend regular screening of [diabetic retinopathy] at baseline and annually thereafter, screening guidelines are not routinely followed,” the researchers wrote. “Because the findings of this review suggest the prevalence of [diabetic retinopathy] increases rapidly with diabetes duration, there is an immediate need for regular screening to be performed consistently.”
Want to learn more about keeping your eyes healthy with diabetes? Read “Diabetic Eye Exams: What to Know,” “Eating for Better Vision and Healthy Eyes,” and “Keeping Your Eyes Healthy” and watch “Diabetes and Your Eyes.”
