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Short-term poor glycemic control and retinal microvascular changes in pediatric Type 1 Diabetes patients in Singapore: a pilot study.

Publication ,  Journal Article
Li, L-J; Lamoureux, E; Wong, TY; Lek, N
Published in: BMC Ophthalmol
June 15, 2017

BACKGROUND: Poor glycemic control in Type 1 Diabetes (T1D) patients is strongly associated with an increased risk of diabetes-related microvascular complications later in life, but it is unclear whether short period of poor glycemic control in children with T1D can cause evident microvascular morphological changes long before any pathological manifestation. Our study aimed to investigate the longitudinal association between poor glycemic control and subsequent changes in retinal microvasculature, in a pilot study of 55 pediatric T1D patients from Singapore after a one-year follow-up. METHODS: This is a hospital-based, exposure-matched and retrospective longitudinal study. A total of 55 T1D patients were included from Singapore KK Women's and Children Hospital, 28 of whom had poor glycemic control (average glycated hemoglobin [HbA1c] ≥8% during the year) while the other 27 age- and gender-matched subjects had good glycemic control (HbA1c <8%). Retinal photography was taken at diabetes annual screening and images were graded by trained graders using a semi-automated computer-based program (Singapore I Vessel Assessment [SIVA], version 4.0, Singapore Eye Research Institute, Singapore) and a spectrum of retinal vascular parameters (e.g. caliber, tortuosity, branching angle and fractal dimension) were measured quantitatively from 0.5 to 2.0 disc diameters. RESULTS: There was no significant difference in ethnicity, duration of T1D, blood pressure, body mass index (BMI) and low-density cholesterol lipoprotein (LDL) between the two groups. Retinal imaging was obtained at the end of 1 year of glycemic control assessment. In multiple linear regression adjusting for ethnicity, BMI, LDL and duration of T1D, patients with poor glycemic control tended to have marginally wider retinal arteriolar caliber (6.0 μm, 95% CI: -0.9, 12.8) and had significantly larger retinal arteriolar branching angle (10.1 degrees, 95% CI: 1.4, 18.9) compared with their age- and gender- matched counterparts with good glycemic control. CONCLUSIONS: Our findings showed that abnormal retinal microvascular morphology was evident in pediatric patients with T1D after one-year's poor glycemic control. Such morphological abnormalities may lead to future development of microvascular complications among T1D pediatric patients with poor glycemic control.

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Published In

BMC Ophthalmol

DOI

EISSN

1471-2415

Publication Date

June 15, 2017

Volume

17

Issue

1

Start / End Page

60

Location

England

Related Subject Headings

  • Time Factors
  • Singapore
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Retinal Vessels
  • Pilot Projects
  • Ophthalmology & Optometry
  • Microvessels
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Li, L.-J., Lamoureux, E., Wong, T. Y., & Lek, N. (2017). Short-term poor glycemic control and retinal microvascular changes in pediatric Type 1 Diabetes patients in Singapore: a pilot study. BMC Ophthalmol, 17(1), 60. https://doi.org/10.1186/s12886-017-0449-8
Li, Ling-Jun, Ecosse Lamoureux, Tien Yin Wong, and Ngee Lek. “Short-term poor glycemic control and retinal microvascular changes in pediatric Type 1 Diabetes patients in Singapore: a pilot study.BMC Ophthalmol 17, no. 1 (June 15, 2017): 60. https://doi.org/10.1186/s12886-017-0449-8.
Li, Ling-Jun, et al. “Short-term poor glycemic control and retinal microvascular changes in pediatric Type 1 Diabetes patients in Singapore: a pilot study.BMC Ophthalmol, vol. 17, no. 1, June 2017, p. 60. Pubmed, doi:10.1186/s12886-017-0449-8.
Journal cover image

Published In

BMC Ophthalmol

DOI

EISSN

1471-2415

Publication Date

June 15, 2017

Volume

17

Issue

1

Start / End Page

60

Location

England

Related Subject Headings

  • Time Factors
  • Singapore
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Retinal Vessels
  • Pilot Projects
  • Ophthalmology & Optometry
  • Microvessels
  • Male