iabetes is a common chronic disease of childhood characterized by chronic hyperglycemia with end-organ damage that often results in the microvascular triad of nephropathy, neuropathy, and retinopathy. 1,2 Subsequent retinal neurodegeneration and breakdown of the bloodretinal barrier progress to diabetic retinopathy, the leading cause of blindness among working-age and young adults. 3,4 Although the ocular sequelae of type 1 diabetes (T1D) and adultonset type 2 diabetes (T2D) have been well described, 1,3-5 little is known concerning the progression of diabetic retinopathy among children with T2D, despite its increasing prevalence in recent years. 6 Current pediatric diabetic retinopathy screening guidelines from the American Academy of Ophthalmology and the American Academy of Pediatrics have evidence-based guidelines for children diagnosed with T1D, whereas data guiding the management of diabetic retinopathy in childhoodonset T2D are limited. 4 The purpose of this study was to assess the risk of developing diabetes-associated ocular complications (DAOC) among a population-based cohort of children diagnosed with either T1D or T2D during a 50-year period.
MethodsThe medical records of all patients younger than 22 years (hereinafter referred to as children) who were newly diagnosed with diabetes from January 1, 1970, through December 31, 2019, in Olmsted County, Minnesota, were retrospectively reviewed. IMPORTANCE Despite the increasing prevalence of type 2 diabetes (T2D) diagnosed in childhood, little is known about the natural history of ocular sequelae in youth-onset T2D compared with type 1 diabetes (T1D).OBJECTIVE To assess the risk of developing diabetes-associated ocular complications among youth diagnosed with diabetes.DESIGN, SETTING, AND PARTICIPANTS This retrospective, population-based medical record review included all residents of Olmsted County, Minnesota (95.7% White in 1990), diagnosed with diabetes at younger than 22 years (hereinafter referred to as children) from