{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:30:07Z","timestamp":1790728207122,"version":"4.1.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Clinically evident microvascular complications are rarely seen among children and adolescents with type 1 diabetes mellitus (T1DM), although early signs develop during childhood and accelerate during puberty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The aim of this study was to determine the prevalence of early signs of microvascular complications in children and adolescents aged 9\u201319 years with a short duration of T1DM by screening for retinopathy and nephropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A cross-sectional study and participants were consecutively enrolled from the Endocrinology Clinic at Federal Teaching Hospital, Abakaliki. Physical examination and mydriatic ophthalmoscopy were conducted. Three early morning spot urine specimens for albumin\/creatinine ratio were estimated 3 months apart. Serum creatinine levels were estimated, and the glomerular filtration rate was calculated. Glycosylated hemoglobin (HbA1c) was determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twenty-four individuals participated, 15 (62.5%) were male and the mean age at diagnosis was 12.4 \u00b1 2.3 years. The mean duration of diabetes was 23.8 \u00b1 20.6 months. The mean HbA1c was 11.4%. Retinopathy was seen in 16.7%, whereas 33.3% had microalbuminuria. Blood pressure range was within the 50\n                      <jats:sup>th<\/jats:sup>\n                      \u201390\n                      <jats:sup>th<\/jats:sup>\n                      percentile for all the participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The study outcome demonstrated a high prevalence of early signs of microvascular complications such as retinopathy and nephropathy among youths with short duration of T1DM. Poor glycemic control, if not halted, is associated with early signs of microvascular complications which may become clinically evident; contrary to the belief that they are rare in childhood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_5_19","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T06:57:25Z","timestamp":1576652245000},"page":"200-205","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Early Signs of Microvascular Complications in Pediatric Patients with Short Duration of Type 1 Diabetes Mellitus Seen in Southeast Nigeria"],"prefix":"10.4103","volume":"18","author":[{"given":"Chinwe Flora","family":"Ogugua","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo Nnenna","family":"Chikani","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Nigeria, Ituku Ozalla Campus, Enugu, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryann Ugochi","family":"Ibekwe","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ngwieri","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Gertrude's Children's Hospital, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holley","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Baystate Children's Hospital\/UMass Medical School, Springfield, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250528","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s00467-010-1624-9","article-title":"Microvascular disease in children and adolescents with type 1 diabetes and obesity","volume":"26","author":"Marcovecchio","year":"2011","journal-title":"Pediatr Nephrol"},{"key":"R2-20250528","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0022-3476(94)70190-3","article-title":"Effect of intensive diabetes treatment on the development and progression of long term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes control and complications trial","volume":"125","year":"1994","journal-title":"J Pediatr"},{"issue":"Suppl 12","key":"R3-20250528","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/j.1399-5448.2009.00576.x","article-title":"Microvascular and macrovascular complications associated with diabetes in children and adolescents","volume":"10","author":"Donaghue","year":"2009","journal-title":"Pediatr Diabetes"},{"key":"R4-20250528","doi-asserted-by":"crossref","first-page":"523","DOI":"10.2337\/diab.36.4.523","article-title":"Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in US population aged 20-74 years","volume":"36","author":"Harris","year":"1998","journal-title":"Diabetes"},{"key":"R5-20250528","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1056\/NEJMoa013410","article-title":"Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes","volume":"347","author":"Lurbe","year":"2002","journal-title":"N Engl J Med"},{"key":"R6-20250528","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1056\/NEJM200002103420603","article-title":"Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy","volume":"342","author":"Lachin","year":"2000","journal-title":"N Engl J Med"},{"issue":"Suppl 12","key":"R7-20250528","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1399-5448.2009.00568.x","article-title":"Definition, epidemiology and classification of diabetes in children and adolescents","volume":"10","author":"Craig","year":"2009","journal-title":"Pediatr Diabetes"},{"key":"R8-20250528","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1056\/NEJM198407123110204","article-title":"Predicting diabetic nephropathy in insulin-dependent patients","volume":"311","author":"Mogensen","year":"1984","journal-title":"N Engl J Med"},{"key":"R9-20250528","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1001\/archopht.1984.01040030398010","article-title":"The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years","volume":"102","author":"Klein","year":"1984","journal-title":"Arch Ophthalmol"},{"key":"R10-20250528","doi-asserted-by":"crossref","first-page":"509","DOI":"10.2337\/diacare.28.3.509","article-title":"The case for biennial retinopathy screening in children and adolescents","volume":"28","author":"Maguire","year":"2005","journal-title":"Diabetes Care"},{"key":"R11-20250528","first-page":"111","article-title":"Socio-economic and cultural background of hospitalized children in Ilesa","volume":"12","author":"Oyedeji","year":"1985","journal-title":"Niger J Paediatr"},{"key":"R13-20250528","first-page":"259","article-title":"Standardized percentile curves of body-mass index for children and adolescents","volume":"145","author":"Hammer","year":"1991","journal-title":"Am J Dis Child"},{"key":"R14-20250528","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1136\/adc.44.235.291","article-title":"Variations in pattern of pubertal changes in girls","volume":"44","author":"Marshall","year":"1969","journal-title":"Arch Dis Child"},{"key":"R15-20250528","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1542\/peds.114.S2.555","article-title":"The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents","volume":"114","year":"2004","journal-title":"Pediatrics"},{"key":"R16-20250528","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/j.1399-543X.2005.00088.x","article-title":"Comparison of fingerstick hemoglobin A1c levels assayed by DCA 2000 with the DCCT\/EDIC central laboratory assay: Results of a diabetes research in children network (DirecNet) study","volume":"6","author":"Tamborlane","year":"2005","journal-title":"Pediatr Diabetes"},{"key":"R17-20250528","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1681\/ASN.2008030287","article-title":"New equations to estimate GFR in children with CKD","volume":"20","author":"Schwartz","year":"2009","journal-title":"J Am Soc Nephrol"},{"key":"R18-20250528","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.2337\/dc11-0102","article-title":"Continued reduction in the prevalence of retinopathy in adolescents with type 1 diabetes: Role of insulin therapy and glycemic control","volume":"34","author":"Downie","year":"2011","journal-title":"Diabetes Care"},{"key":"R19-20250528","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1136\/adc.2011.210807","article-title":"Prevalence of retinopathy in Finnish children and adolescents with type 1 diabetes: A cross-sectional population-based retrospective study","volume":"96","author":"Kubin","year":"2011","journal-title":"Arch Dis Child"},{"key":"R20-20250528","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1136\/bmj.306.6892.1570","article-title":"Prospective study of incidence of juvenile diabetes mellitus over 10 years in Dar Es Salaam, Tanzania","volume":"306","author":"Swai","year":"1993","journal-title":"BMJ"},{"key":"R21-20250528","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.2337\/diacare.15.10.1310","article-title":"Prevalence and clinical picture of IDDM in Nigerian Igbo schoolchildren","volume":"15","author":"Afoke","year":"1992","journal-title":"Diabetes Care"},{"key":"R22-20250528","doi-asserted-by":"crossref","first-page":"205","DOI":"10.2337\/diab.36.2.205","article-title":"Declining incidence of persistent proteinuria in type I (insulin-dependent) diabetic patients in Denmark","volume":"36","author":"Kofoed-Enevoldsen","year":"1987","journal-title":"Diabetes"},{"key":"R23-20250528","first-page":"55","article-title":"Early onset of diabetic nephropathy in a child with type 1 diabetes mellitus","volume":"45","author":"Bayazit","year":"2003","journal-title":"Turk J Pediatr"},{"key":"R24-20250528","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.diabet.2007.03.004","article-title":"Prevalence of diabetic retinopathy in children and adolescents with type-1 diabetes attending summer camps in France","volume":"33","author":"Massin","year":"2007","journal-title":"Diabetes Metab"},{"key":"R25-20250528","first-page":"109","article-title":"Microalbuminuria and its association with risk factors among type 1 diabetes mellitus patients attending a tertiary care hospital: A cross-sectional study","volume":"1","author":"Gupta","year":"2013","journal-title":"Int J Healthc Biomed Res"},{"key":"R26-20250528","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.nephro.2009.08.001","article-title":"Prevalence and determinants of microalbuminuria and macroalbuminuria in children and young adults with type 1 diabetes in Kinshasa","volume":"6","author":"Rissassi","year":"2010","journal-title":"Nephrol Ther"},{"key":"R27-20250528","doi-asserted-by":"crossref","first-page":"495","DOI":"10.2337\/diacare.22.3.495","article-title":"Microalbuminuria prevalence varies with age, sex, and puberty in children with type 1 diabetes followed from diagnosis in a longitudinal study. Oxford regional prospective study group","volume":"22","author":"Schultz","year":"1999","journal-title":"Diabetes Care"},{"key":"R28-20250528","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1111\/j.1523-1755.2005.00590.x","article-title":"The relationship between microalbuminuria and glomerular filtration rate in young type 1 diabetic subjects: The oxford regional prospective study","volume":"68","author":"Amin","year":"2005","journal-title":"Kidney Int"},{"key":"R29-20250528","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1471-2369-8-2","article-title":"Microalbuminuria among type 1 and type 2 diabetic patients of African origin in Dar Es Salaam, Tanzania","volume":"8","author":"Lutale","year":"2007","journal-title":"BMC Nephrol"},{"key":"R30-20250528","doi-asserted-by":"crossref","first-page":"955","DOI":"10.2337\/diacare.18.7.955","article-title":"Diabetes in urban African-Americans. II. High prevalence of microalbuminuria and nephropathy in African-Americans with diabetes","volume":"18","author":"Goldschmid","year":"1995","journal-title":"Diabetes Care"},{"key":"R31-20250528","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1136\/bmj.296.6616.156","article-title":"Prevalence of microalbuminuria, arterial hypertension, retinopathy and neuropathy in patients with insulin dependent diabetes","volume":"296","author":"Parving","year":"1988","journal-title":"Br Med J (Clin Res Ed)"},{"key":"R32-20250528","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1001\/archinte.1994.00420060047005","article-title":"Early diabetic nephropathy","volume":"154","author":"Carella","year":"1994","journal-title":"Arch Internal Med"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_5_19","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:08:18Z","timestamp":1787774898000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_5_19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":31,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_5_19","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}