Aim To evaluate the usefulness of performing annual screening in children less than 12 years but more than 5 years since the diagnosis of diabetes and to review if we can safely screen children by following NICE guidance CG15.
Methods We retrospectively analysed the annual screening results of 22 children who had annual screening performed 5 years after the diagnosis of type 1 diabetes, but were less than 12 years old. The parameters taken into account were latest HbA1C, BMI, thyroid function test, coeliac screen, microalbuminuria and blood pressure
Results Out of 107 children with type 1 diabetes, 22 children (20.7%) had annual screening performed before 12 years of age, but 5 years after the diagnosis. The age of these children varied from 5.5 years to 11 years. Thyroid perioxidase antibody levels (TPO) were high in five patients (23%). One patient had autoimmune hypothyroidism and was started on thyroxine treatment. Transient microalbuminuria was noted in two patients. High tissue transglutaminase IgA antibody levels (TTG) were noted in two patients. Jejunal biopsy was negative for coeliac disease in one patient and the other patient moved out of the area. Blood pressure was within normal limits in all patients.
Conclusion By performing annual screening in children less than 12 years, we identified one child with asymptomatic autoimmune hypothyroidism who needed thyroxine treatment. Although other abnormalities like transient microalbuminuria, raised TPO and TTG levels were noted, none of them needed any treatment. Larger studies are needed to evaluate if we can safely follow NICE guidance on performing annual screening in children with Type 1 diabetes.
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