The presence of background and preproliferative retinopathy in 70 patients with type I diabetes was correlated with their pubertal development. Pubertal status was assessed by pediatricians using the sexual maturity ratings of Tanner. In young diabetics with comparable disease duration (5 to 10 years), postpubertal children had a greater prevalence of retinopathy than those who were not sexually mature. After adjusting for duration of diabetes and sex, the relative odds of having retinopathy in the postpubescent group relative to the prepubescent or pubescent groups was 4.8 (95% confidence interval: 1.5 to 15.3). This study suggests that minimal retinopathy in children is not rare and that postpubescent children have a greater prevalence of diabetic retinopathy than do prepubescent children with similar diabetes duration.
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