The prevalence of type 2 diabetes in children has been increasing in recent years, but little is known about the progression of diabetic retinopathy in this population. Researchers investigated the risk of developing diabetes-associated ocular complications in a population-based cohort of children diagnosed with type 1 or type 2 diabetes.

The researchers reviewed the medical records of all patients younger than 22 years who were newly diagnosed with diabetes during a 50-year period. Of 606 children (mean age, 12.1 years) diagnosed with diabetes, 525 underwent at least one eye examination.

Diabetes-associated ocular complications developed in 147 of the 461 children with type 1 diabetes (31.9%) during a mean follow-up of 14 years and 17 of the 64 children with type 2 diabetes (26.6%) during a mean follow-up of nine years. The hazard ratios illustrating the risk between the type 2 diabetes and type 1 diabetes rates of developing complications was 1.88 for developing any diabetic retinopathy, 2.33 for proliferative diabetic retinopathy, 1.49 for diabetic macular edema, 2.43 for a visually significant cataract, and 4.06 for requiring pars plana vitrectomy by 15 years after the diagnosis of diabetes.

The authors point out that since this was a retrospective study, the findings are limited because of incomplete data and irregular follow-up. Other limitations are that the number of children diagnosed with type 2 diabetes was relatively small and the population was predominantly White. In addition, the management of diabetes has changed over the 50-year study period, the authors point out, making comparisons of patients across decades difficult.