Microvascular complications in children and adolescents with type 1 diabetes

Abstract

The increasing incidence of type 1 diabetes in children and adolescents emphasizes the need to focus on potential diabetic complications as well. These complications may also occur subclinically and increase at the onset of puberty. In type 1 diabetes, the absence of microvascular complications such as nephropathy, retinopathy, and neuropathy is associated with a life expectancy comparable with that of the general population. Therefore, successful screening and prevention of microvascular complications play a key role in managing younger diabetic patients. The frequency of screening for nephropathy, retinopathy, and neuropathy has been summarized in guidelines, and also depends on age, diabetes duration, and individual risk factors such as family predisposition, puberty, and elevated blood pressure. Optimized glycaemic control plays a key role in efficiently reducing the risk and progression of all microvascular complications. Current consensus recommendations for symptomatic pharmacological treatment of painful diabetic peripheral neuropathy include anticonvulsants; studies have also shown that the thiamine prodrug benfotiamine (S-benzoylthiamine-O-monophosphate) may prevent the formation of advanced glycation end products (AGEs), and may therefore improve early nerve dysfunction in adolescents with type 1 diabetes. The aim of this paper was to review the epidemiology, screening and prevention of microvascular complications from type 1 diabetes in younger patients.