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October 9, 2001


Question from Simi Valley, California, USA:

My 10 year old daughter is coming upon her fifth year with diabetes, and I have read that after the fifth year, children with diabetes can begin to show the wear that diabetes takes on their bodies. I'm wondering what complications may start and signs I should watch for.


How terrific of you to be so proactive, and hopefully, your daughter’s diabetes team is as well. Before puberty, assuming fairly good control, the various complications of diabetes are usually screened within three to five years of the initial diagnosis of diabetes. After puberty, many centers will screen annually.

The screening issues should include:

A comprehensive eye exam, including dilation of the eye, which is perhaps done best by an ophthalmologist rather than an optometrist, but speak with your diabetes team as to who they usually refer to.
A urine collection for microalbumin. Screening can be done on a random urine collection, but sometimes a specifically timed 12 hour nighttime or complete 24 hour urine collection in needed.
Many centers will start obtaining fasting blood for cholesterol and triglycerides (fat) levels.
Other screening can include looking for concurrent conditions that might affect your child’s health and include screening for other autoimmune system related diseases such as thyroid, disease, celiac disease, or Addison’s disease.

Bottom line? Keep communicating with your daughter’s diabetes team and pediatric diabetes specialist.