Department of Pediatrics, Tongji Hospital, Tongji Medical College, 12443 Huazhong University of Science and Technology , Wuhan, China.
Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Pediatr Endocrinol Metab. 2024 May 31;37(7):652-656. doi: 10.1515/jpem-2024-0005. Print 2024 Jul 26.
To analyze and summarize the clinical characteristics and treatment of juvenile patients with type 1 diabetes mellitus (T1DM) complicated by early cataract.
This retrospective study collected clinical data from 210 children and adolescents newly diagnosed with T1DM who were admitted to the Department of Pediatrics, Tongji Hospital (Wuhan) between 2015 and 2022. Among 210 patients with T1DM, early cataract developed within 3 months before diabetes onset and 12 months thereafter in 2 (0.95 %) patients. The two patients were both females, aged 13 and 9 years, respectively. In both cases, cataracts in both eyes appeared in the early stages of T1DM, showing a short course and rapid development. After intensive insulin treatment for stringent and stable blood glucose control, one patient underwent cataract extraction with significant improvement, and her visual acuity returned to normal. The other patient received intensive insulin therapy and insulin pump therapy for 8 years. Subsequently, she underwent cataract surgery after achieving stable blood glucose levels, without complete recovery of vision.
Cataract is a rare complication in the early stages of T1DM in children and adolescents. Ophthalmic surgery is the preferred treatment for patients with diabetic cataract after achieving stable glycemic control, which may help prevent visual impairment.
分析并总结 1 型糖尿病(T1DM)幼年患者并发早期白内障的临床特点和治疗方法。
本回顾性研究收集了 2015 年至 2022 年期间在同济医院儿科新诊断为 T1DM 的 210 名儿童和青少年的临床资料。在 210 例 T1DM 患者中,有 2 例(0.95%)患者在糖尿病发病前 3 个月至发病后 12 个月内发生早期白内障。这 2 名患者均为女性,年龄分别为 13 岁和 9 岁。在这两例中,双眼白内障均在 T1DM 的早期出现,病程短,发展迅速。经过强化胰岛素治疗以严格控制血糖稳定后,1 例患者行白内障摘除术,视力明显改善,恢复正常。另 1 例患者接受强化胰岛素治疗和胰岛素泵治疗 8 年。此后,在血糖水平稳定后行白内障手术,但视力未完全恢复。
白内障是儿童和青少年 T1DM 早期的罕见并发症。对于糖尿病性白内障患者,在血糖控制稳定后行眼科手术是首选治疗方法,这有助于预防视力损害。