AI Article Synopsis
- The study analyzed data from a large pediatric diabetes registry (92,633 patients) to investigate the occurrence of cataracts in children and adolescents with type 1 diabetes, finding 235 cases of diabetic cataract.
- It categorized 200 patients into early cataract (developing 3 months before to 12 months after diabetes onset) and late cataract (more than 12 months after onset), noting that those with early cataracts were older and had higher HbA1c levels at diabetes onset.
- Results indicate that cataract development peaks at diabetes onset and diminishes with longer diabetes duration, with hyperglycemia believed to be the main cause of early cataract formation.
Article Abstract
Objective: To study diabetic cataract in type 1 diabetes in a large pediatric cohort.
Methods: The 92,633 patients aged 0.5-21 years from German/Austrian multicenter diabetes registry (DPV) were analyzed. The 235 patients (0.25%) with diabetic cataract were found, 200 could be categorized: 67 with early cataract (3 months before diabetes onset - 12 months afterwards), 133 with late cataract (>12 months after diabetes onset). Regression models adjusted for age and gender were used to compare clinical parameters at diabetes onset. Regression models for patients with late cataract were implemented for the total documentation period and additionally adjusted for diabetes duration.
Results: Rate of cataract development shows a peak at diabetes onset and declines with longer diabetes duration. Patients with cataract showed strong female preponderance. Patients developing early cataract were older at diabetes onset (12.8 years [11.8/13.9] vs. 8.9 [8.9/9.0]; p < 0.001) and showed higher HbA1c than patients without cataract (9.0% [8.55/9.38] vs. 7.6% [7.60/7.61]; p < 0.001). They had lower height-SDS, (-0.22 [-0.48/0.04] vs. 0.25 [0.24/0.26]; p < 0.001), lower weight-SDS (-0.31 [-0.55/-0.08] vs. 0.21 [0.20/0.21]; p < 0.001) and lower BMI-SDS (-0.25 [-0.49/-0.02] vs. 0.12 [0.12/0.13); p = 0.002). Patients with late cataract showed higher HbA1c at diabetes onset (8.35% [8.08/8.62] vs. 8.04% [8.03/8.05]; p = 0.023) and higher mean HbA1c during total documentation period (8.00% [7.62/8.34] vs. 7.62% [7.61/7.63]; p = 0.048).
Conclusions: Our data confirm known demographic and clinical characteristics of patients developing early cataract. Hyperglycemia-induced osmotic damage to lens fibers at diabetes onset might be the main pathomechanism. Long term glycemic control is associated with cataract development.
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| http://dx.doi.org/10.1111/pedi.13316 | DOI Listing |
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