Background: This work is to evaluate the frequency of diabetic retinopathy, and to assimilate its impact in young diabetics followed at the endocrinology-diabetology department at the Children's Hospital of Rabat. Thus, patients with this complication were compared to patients without it, in order to demonstrate the various parameters that influence the appearance of diabetic retinopathy: age of diagnosis, duration of evolution, glycemic balanceMaterial and Methods: 200 children and young people with type 1 diabetes, aged between 5 and 28 years, who are followed up in the Department of Diabetology and Endocrinology at the C.H.U -Rabat. We analyzed their clinical and biological parameters during 12 months. Their glycemic control was evaluated by the determination of glycated hemoglobin by DCA 2000. The patients underwent a fundus examination followed by angiography to screen for retinopathy.Results: 28% of patients had good glycemic control with HbAlc < 7.5%; 16% had a of HbA1c: 7.5 % - 8.31% have an average HbA1c: 8% - 9%; 24% have a poor glycemic balance: HbA1c between 9 - 14% and 2% have an HbA1c > 14%. The duration of diabetes is the best predictor of the occurrence of retinopathy, the prevalence of which increases with the duration of diabetes. 50% of the patients, i.e. half of the male community, belong to the age of onset group > 5 years and up to 10 years. 57% of the patients with a duration of diabetes > 6 years up to more than 15 years have a retinopathy. There is a predominance of the male sex with a frequency of 65% who have retinopathy. The frequency of diabetic retinopathy increases with the length of diabetes, from 14% before 10 years of diabetes to 31% after 10 years. After 17 years of diabetes, 100% of patients have diabetic retinopathy, often accompanied by other complications. The majority of patients with DR have a poor average glycated hemoglobin between 8 and 9% and a very poor glycemic control with a rate between 9 and 14%.Conclusion: This original work shows that the frequency of diabetic retinopathy is influenced by two factors: the length of diabetes and the level of glycated hemoglobin. A too high level with a duration of evolution of more than 10 years increases the incidence of this pathologyThe implementation of educational programs and the follow-up of hygienic and dietary measures within the framework of an organized management of diabetes has made it possible to significantly reduce the intensity and severity of complications, the cost of the disease and to improve the daily comfort of diabetics.
Asmae Touzani, Layachi Chabraoui, Nouzha Rami, Khalid Taghzouti, Amina Balafrej. Relationship between retinopathy and glycated heamoglobin in insulin dependent diabetic children and adolescents. International Journal of Medical and Health Research, Volume 7, Issue 7, 2021, Pages 53-59