Elevated Albumin Excretion and Retinal Changes in Children with Type 1 Diabetes are Related to Long‐term Poor Blood Glucose Control

Abstract

All diabetic children (n = 113) under 19 years old and with more than 2 years of diabetes attending the Steno Memorial Hospital in 1987 were studied. Normal urinary albumin excretion (< 30 mg 24 h⁻¹) was found in 96 patients (85%), 15 had microalbuminuria (30–300 mg 24 h⁻¹) (13%), and 2 patients were proteinuric (>300 mg 24 h⁻¹) (2%). Retinal morphology was evaluated by colour fundus photography. Background retinopathy was more frequent in the group with elevated albumin excretion (71%) than in a matched normoalbuminuric group (20%, 2p < 0.001). Long‐term blood glucose control was assessed from all previous HbA_1c measurements in the hospital records, an average of nine per patient. The mean observation period was 48 (3–76) months. Children with elevated albumin excretion had a higher mean HbA_1c than children with normal urinary albumin excretion (10.3 ± 1.9 vs 9.2 ± 1.3% (± SD), 2p < 0.05). Children with retinopathy had an HbA_1c of 9.9 ± 1.7 vs 9.0 ± 1.2% in patients without retinopathy (2p < 0.01).