My three and a half year old son has had diabetes for about two and a half years. When must he have an eye test? Must we do the A1c test every three to four months ?

As long as your son is thought to be in good control as judged by his three monthly hemoglobin A1c test and there are no minor eye problems at his routine medical visits, I don’t think that he needs to be seen by an ophthalmologist until he is about ten years old. After that, visits need only be annually unless some evidence of diabetic retinopathy develops, which is most unlikely before the late teen years.

DOB

[Editor’s comment: The ISPAD Consensus Guidelines for the Management of Insulin-Dependent (Type 1) Diabetes (IDDM) in Childhood and Adolescence 2000 state the following:

Age of retinopathy screening

Prepubertal onset of diabetes: 5 years after onset or at age 11 years, or at puberty (whichever is earlier), and annually thereafter
Pubertal onset of diabetes: 2 years after onset, and annually thereafter

Glycated hemoglobin

Frequency of measurement will depend on local facilities and availability, but good clinical practice would suggest that there should be four to six measurements per year in younger children, three to four measurements per year in older children, and a minimum of one measurement per year in all children

SS]