Screening for Eye Kidney and Nerve Complications - Diabetesinfo.no

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Screening for Eye Kidney and Nerve Complications

Over the years, diabetes can damage the kidneys, eyes and nerves. If the symptoms are found and treated early, further damage can be prevented. This is why these tests are so important. These tests are done when the child is nine and twelve years old. After age twelve, they should be done annually.

Urine test for albumin (microalbuminuria)

Over the years, diabetes can damage the kidneys. When blood sugar and blood pressure are kept under good control, however, the risk of developing diabetic kidney disease (nephropathy) is very small. In the early stages of kidney disease, small amounts of albumin leak into the urine. This is called microalbuminuria. If microalbuminuria is detected early, it can be often be cured by improving blood sugar control. Sometimes other treatment is started as well.

If leakage of albumin into the urine exceeds 20 µg/min, blood sugar control, as measured by HbA1c, should be improved over the next six months. If this does not work, medication to reduce blood pressure is given to prevent further kidney disease.
Blood pressure should be checked regularly and kept within normal limits.

The test for microalbuminuria requires urine collection. Instructions and supplies are provided by the laboratory technicians. Urine is then collected from two nights. A sample from each night's urine is sent to the lab with notes indicating the time of collection and the total amount of urine collected.

Eye examination

Diabetic eye disease (retinopathy) is common after several years of diabetes. Early changes in the back of the eyes (the retina) cannot be felt, and sight will usually not be affected until it is too late to begin treatment. That's why it's important to have annual eye examinations beginning at puberty. Early treatment can prevent further eye damage.

The main treatment for diabetic retinopathy in its early stages is good blood sugar control as measured by HbA1c. If eye changes pose a threat to sight, laser treatments will be started.

Eye examination begins with a normal eye test. Eye drops are then used to enlarge and sedate the pupils. After about 30 minutes, the eye doctor uses special equipment to look through the pupil at the back of the eye. The doctor may also take pictures of the retina.

Testing the ability to feel vibration

Diabetic nerve disease (neuropathy) is common in adults who have had diabetes for several years. It rarely occurs in children and adolescents, but early changes in the nerves are sometimes found in this age group. When diabetic neuropathy is found and treated early, further damage can be prevented. The main treatment of early diabetic nerve disease is to improve blood sugar control as measured by HbA1c.

Testing the ability to feel vibration is not uncomfortable. A vibrating device is gently held against the index finger and big toe. The doctor asks the child to say when he or she begins to feel vibrations. The time it takes the child to begin feeling vibrations is measured in "volts" and should be below a certain level depending on the child's age.

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