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Chapter 18: Microvascular and macrovascular complications in children and adolescents
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Dear Members,
Dear Friends
 
Diabetes complications are what people with diabetes and their families are the most afraid of, no matter what age the person is. The younger the age at diagnosis is, the longer the journey with this chronic illness will be.
Clinically evident diabetes-related vascular complications are rare in childhood and adolescence. However, early functional and structural abnormalities may be present a few years after the onset of the disease. Childhood and adolescence is a period during which intensive education and treatment may prevent or delay the onset and progression of complications.
The long-term vascular complications of diabetes include nephropathy, retinopathy, neuropathy, and macrovascular disease. Vascular complications remain a key contributor to mortality in young people with an onset of diabetes during childhood. Fortunately, there has been a declining incidence of complications reported in many areas with specialized clinics. This has occurred over a period of time during which there have been major changes and intensification of diabetes management, identification of putative risk factors, and the advent of regular screening for complications. There is no evidence that this is a worldwide occurrence: in areas where health care is not optimal, a greater risk of complications will remain.

This ISPAD chapter focuses on diabetes complications in the youngest people with diabetes and recommends to start screening for microvascular complications at age 11.
Learn more about The state of art on Diabetes Complications - The latest in Retinopathy and New Treatments by Rafael Simo. Check the lectures about Marcovascular disease in the Young also: Jenny Couper asks “Can we intervene earlier?”. Gerald Watts presents about “Statins for all diabetic patients: the lower and the earlier the better?.


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