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Eye Screening

Can Eye Screening for Diabetic Kids Be Delayed a Bit?

Original article written by Robert Preidt via HealthDay News on September 9, 2015. Click here to read the original article.

Children with type 1 diabetes may not need to start screening for eye disease as early as currently recommended, a new study suggests.Can Eye Screening for Diabetic Kids Be Delayed a Bit?

Most children with type 1 diabetes probably don’t need a yearly exam for diabetes-related eye disease (diabetic retinopathy) until age 15, or 5 years after their diabetes diagnosis, whichever is later, the study authors reported online Sept. 1 in the journal Ophthalmology.

“Many of our young patients with diabetes diligently come in every year for screenings that consistently show no sign of the disease,” study co-author Dr. Gil Binenbaum, attending surgeon in the ophthalmology division at The Children’s Hospital of Philadelphia, said in a journal news release.

“Of course, that’s good news for them, and it is very important to have annual eye exams once the risk of vision loss develops. But, is it worth the burden on the family and the health care system if evidence shows that diabetic retinopathy doesn’t reach a treatable stage until years later?”

Early detection and treatment of diabetic retinopathy reduces vision loss in adults, the researchers said. Some medical groups currently recommend that screening start at age 9, or three to five years after a type 1 diabetes diagnosis.

But, this study found no evidence of diabetic retinopathy in 370 children who had at least one screening. And, that was true regardless of how long they had diabetes. It was also true whether their blood sugar levels were well controlled or not, the research showed. The children were all 18 or younger, and had type 1 or type 2 diabetes.

Children with type 2 diabetes and those at high risk for diabetic complications should begin screening as soon as they are diagnosed with diabetes, the study authors said. Many people with type 2 diabetes live with uncontrolled disease before they are diagnosed, the researchers explained.

Diabetic retinopathy is the leading cause of blindness among working-age Americans, according to the U.S. National Eye Institute (NEI). The eye disease affects nearly 8 million people in the United States, the NEI said.

More information

The U.S. National Eye Institute has more about diabetic retinopathy.

SOURCE: Ophthalmology, news release, Sept. 1, 2015

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Role of the integrated stress response in type 1 diabetes pathogenesis
In individuals with type 1 diabetes (T1D), the insulin-producing beta cells are spontaneously destroyed by their own immune system. The trigger that provokes the immune system to destroy the beta cells is unknown. However, accumulating evidence suggest that signals are perhaps first sent out by the stressed beta cells that eventually attracts the immune cells. Stressed cells adapt different stress mitigation systems as an adaptive response. However, when these adaptive responses go awry, it results in cell death. One of the stress response mechanisms, namely the integrated stress response (ISR) is activated under a variety of stressful stimuli to promote cell survival. However, when ISR is chronically activated, it can be damaging to the cells and can lead to cell death. The role of the ISR in the context of T1D is unknown. Therefore, in this DRC funded study, we propose to study the ISR in the beta cells to determine its role in propagating T1D.
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