Eyes and Kidneys

These two checks are the ones most often skipped, because a child who feels perfectly well seems not to need them. That is exactly why they exist: both problems are silent until they are advanced.

Eyes. Diabetes can damage the small blood vessels at the back of the eye, in the retina. Vision is unaffected until quite late, so a child will never complain in time. The examination uses drops to widen the pupils so the whole retina can be seen or photographed.

Preparing a child helps a great deal: the drops sting briefly, vision goes blurry for a few hours, and bright light is uncomfortable afterwards. Sunglasses and a promise of something afterwards make the second appointment much easier than the first.

Among Indian children with diabetes followed for three years or more, retinopathy was found in 13.4% — not a small number, and treatable when found early.

Kidneys. The kidneys filter blood through millions of tiny vessels, and high blood sugar damages them over time. Two tests together give the picture: a urine sample checked for albumin, a protein that leaks when the filters are damaged, and a blood test for creatinine to estimate filtering.

Kidney changes were found in 7.1% of that same group of children. Early changes can often be slowed with better control, blood pressure treatment, and specific medicines.

One raised urine result does not mean kidney disease — infection, fever or exercise can all cause it — so an abnormal result is repeated before anything is concluded.

Ask for the actual numbers at each review rather than being told they were fine, and keep them. A value drifting across three years tells you something a single result cannot.