Risk of proliferative diabetic retinopathy in juvenile-onset type I diabetes: a 40-yr follow-up study
Risk of proliferative diabetic retinopathy in juvenile-onset type I diabetes: a 40-yr follow-up study. A S Krolewski , J H Warram , L I Rand , A R Christlieb , E J Busick and C R Kahn Abstract The development of proliferative diabetic retinopathy was studied in three cohorts consisting of 292 patien...
Saved in:
Published in | Diabetes care Vol. 9; no. 5; pp. 443 - 452 |
---|---|
Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
American Diabetes Association
01.09.1986
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Risk of proliferative diabetic retinopathy in juvenile-onset type I diabetes: a 40-yr follow-up study.
A S Krolewski ,
J H Warram ,
L I Rand ,
A R Christlieb ,
E J Busick and
C R Kahn
Abstract
The development of proliferative diabetic retinopathy was studied in three cohorts consisting of 292 patients with recent
juvenile-onset, type I (insulin-dependent) diabetes who were followed 20-40 yr beginning in 1939, 1949, and 1959. The risk
of this severe eye complication was almost nonexistent during the first 10 yr of diabetes, rose abruptly to its maximum level
(approximately 30/100 person-years), and remained at that level for the next 25 yr. This pattern did not vary with sex, age
at onset of diabetes, or level of glycemic control during the first 5 yr of diabetes. However, the risk of proliferative retinopathy
was strongly related to the level of glycemic control during the several years preceding onset of this complication. This
was a dose-dependent relationship, with patients in the highest quartile of the distribution of the index of frequency of
hyperglycemia having a 10-fold higher risk than individuals in the lowest quartile. A virtually identical pattern was observed
in patients who developed diabetes in 1959 as was observed in those who developed diabetes in 1949 or 1939. In contrast, diabetic
nephropathy as evidenced by persistent proteinuria showed a lower incidence in the 1959 than in the 1939 cohort. In conclusion,
these incidence data do not support the notion that the risk of proliferative retinopathy is mainly a function of duration
of diabetes. Instead, the pattern of occurrence of this severe eye complication in type I diabetes suggests that the process
leading to the development of proliferative retinopathy consists of two or more stages and that progression through each stage
may be governed by different factors. |
---|---|
Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0149-5992 1935-5548 |
DOI: | 10.2337/diacare.9.5.443 |