A new review published in Pediatric Diabetes has found that children with diabetes may begin to show early signs of nerve and blood vessel damage in their legs and feet before the age of 18. These complications, known as neuropathy (nerve damage) and vasculopathy (blood vessel problems), are well-known in adults with diabetes, but this study highlights the need for better screening and care in younger patients.

Researchers performed a systematic review of 18 studies involving 3,533 children, most of whom (95%) had type 1 diabetes. The children were between 3.5 and 18 years old. The studies employed a wide range of tests to assess nerve and blood vessel health in the lower limbs, including assessments of sensation, reflexes, muscle tone, and blood flow.

Results reported a wide variation in the reported rates of these complications. Clinical signs of nerve damage were found in anywhere from 0% to 57.1% of children, while vascular issues ranged from 0% to 37.8%. One long-term study found a 2.6 times increase in neuropathy over five years. A meta-analysis further estimated that up to 7% of children might show abnormal results in nerve tests.

Current clinical guidelines do not clearly state how often children with diabetes should be checked for these complications, and more high-quality research is needed to support evidence-based recommendations.