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The Hospital for Sick Children

Screening for Type 1 Diabetes

Screening Recommendations for Complications in Children with Type 1 Diabetes Mellitus

Risk Factors for Diabetes Related Complications:

  • Disease duration
  • Poor metabolic control (high HbA1c)
  • High blood pressure
  • Family history
  • High serum lipids
  • Smoking
  • Puberty


    1. If normal, repeat in mid-puberty
    2. If abnormal, screen family for hyperlipidemia and follow-up patient

4. Retinopathy

    1. Annual exam through dilated pupils starting at age 15 years and diabetes duration of 5 years
    2. More frequent assessment if positive findings

5. Nephropathy

    1. annual timed urine collections for microalbumin excretion rate (overnight or 24-hr collection) starting at puberty and diabetes duration of 3-5 years
    2. if positive, confirm with repeat testing every 3 months x2

6. Neuropathy - No routine screening required

7. Macrovascular Disease - No routine screening required

Other Surveillance:

  • Thyroid function studies - annually
  • Anti-endomyseal antibodies - based on clinical suspicion of celiac disease