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The temporal development of retinopathy and nephropathy in type 1 diabetes mellitus during 15 years diabetes duration

Lövestam Adrian, Monica LU ; Agardh, Elisabet LU and Agardh, Carl-David LU (1999) In Diabetes Research and Clinical Practice 45(1). p.15-23
Abstract
In this prospective study, the 10- and 15-year incidence and course of retinopathy were examined in relation to medical risk indicators from 3.1 +/- 1.9 (mean -/+ SD) years diabetes duration and onwards in 29 adult type 1 diabetic patients treated under routine care. A total of 28 patients were followed for 10 years and 20 patients for 15 years diabetes duration. After 10 years diabetes duration, 11 patients had developed any retinopathy (ten patients background retinopathy and one patient clinically-significant macular oedema). After 15 years diabetes duration, 16 patients had developed any retinopathy (12 patients developed background retinopathy and four patients developed potentially sight-threatening retinopathy, i.e. clinically... (More)
In this prospective study, the 10- and 15-year incidence and course of retinopathy were examined in relation to medical risk indicators from 3.1 +/- 1.9 (mean -/+ SD) years diabetes duration and onwards in 29 adult type 1 diabetic patients treated under routine care. A total of 28 patients were followed for 10 years and 20 patients for 15 years diabetes duration. After 10 years diabetes duration, 11 patients had developed any retinopathy (ten patients background retinopathy and one patient clinically-significant macular oedema). After 15 years diabetes duration, 16 patients had developed any retinopathy (12 patients developed background retinopathy and four patients developed potentially sight-threatening retinopathy, i.e. clinically significant macular oedema (n = 2) or severe non-proliferative retinopathy (n = 2)). None of the patients developed proliferative retinopathy. No differences were seen in mean HbA1c values between patients without any retinopathy and patients with background retinopathy, whereas patients who developed potentially sight-threatening retinopathy had higher mean HbA1c levels than patients without any retinopathy. Patients who developed potentially sight-threatening retinopathy had higher levels of mean HbA1c both after 10 (9.7 +/- 1.6 vs 6.9 +/- 1.5%; P < 0.05) and 15 years diabetes duration (9.3 +/- 1.2 vs 7.1 +/- 1.3%; P < 0.05), compared to patients without any retinopathy. They also had higher levels of mean HbA1c than patients with background retinopathy after 15 years diabetes duration (9.3 +/- 1.2 vs 7.7 +/- 1.1%; P < 0.05). There were no differences in blood pressure levels between patients who developed retinopathy and those who did not. Only two patients developed clinical signs of nephropathy (urinary albumin 320-1590 mg/l) after 12 and 13 years diabetes duration, respectively. At those time points, both patients had already developed background retinopathy since 2 years. In conclusion, the present study shows that the incidence of retinopathy is associated with the duration of diabetes and that there is a strong association between the degree of metabolic control and development of potentially sight-threatening retinopathy. The study also indicates that the development of retinopathy does not seem to be associated with hypertension or clinical signs of nephropathy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Retinopathy, Nephropathy, Metabolic control, Duration, Routine care, Diabetes mellitus
in
Diabetes Research and Clinical Practice
volume
45
issue
1
pages
15 - 23
publisher
Elsevier
external identifiers
  • pmid:10499881
  • scopus:0345120663
ISSN
1872-8227
DOI
10.1016/S0168-8227(99)00055-8
language
English
LU publication?
yes
id
f69a34c2-ecf4-4294-8fbe-2275e9bb3e68 (old id 1114146)
date added to LUP
2008-07-03 13:59:39
date last changed
2017-01-01 05:10:29
@article{f69a34c2-ecf4-4294-8fbe-2275e9bb3e68,
  abstract     = {In this prospective study, the 10- and 15-year incidence and course of retinopathy were examined in relation to medical risk indicators from 3.1 +/- 1.9 (mean -/+ SD) years diabetes duration and onwards in 29 adult type 1 diabetic patients treated under routine care. A total of 28 patients were followed for 10 years and 20 patients for 15 years diabetes duration. After 10 years diabetes duration, 11 patients had developed any retinopathy (ten patients background retinopathy and one patient clinically-significant macular oedema). After 15 years diabetes duration, 16 patients had developed any retinopathy (12 patients developed background retinopathy and four patients developed potentially sight-threatening retinopathy, i.e. clinically significant macular oedema (n = 2) or severe non-proliferative retinopathy (n = 2)). None of the patients developed proliferative retinopathy. No differences were seen in mean HbA1c values between patients without any retinopathy and patients with background retinopathy, whereas patients who developed potentially sight-threatening retinopathy had higher mean HbA1c levels than patients without any retinopathy. Patients who developed potentially sight-threatening retinopathy had higher levels of mean HbA1c both after 10 (9.7 +/- 1.6 vs 6.9 +/- 1.5%; P &lt; 0.05) and 15 years diabetes duration (9.3 +/- 1.2 vs 7.1 +/- 1.3%; P &lt; 0.05), compared to patients without any retinopathy. They also had higher levels of mean HbA1c than patients with background retinopathy after 15 years diabetes duration (9.3 +/- 1.2 vs 7.7 +/- 1.1%; P &lt; 0.05). There were no differences in blood pressure levels between patients who developed retinopathy and those who did not. Only two patients developed clinical signs of nephropathy (urinary albumin 320-1590 mg/l) after 12 and 13 years diabetes duration, respectively. At those time points, both patients had already developed background retinopathy since 2 years. In conclusion, the present study shows that the incidence of retinopathy is associated with the duration of diabetes and that there is a strong association between the degree of metabolic control and development of potentially sight-threatening retinopathy. The study also indicates that the development of retinopathy does not seem to be associated with hypertension or clinical signs of nephropathy.},
  author       = {Lövestam Adrian, Monica and Agardh, Elisabet and Agardh, Carl-David},
  issn         = {1872-8227},
  keyword      = {Retinopathy,Nephropathy,Metabolic control,Duration,Routine care,Diabetes mellitus},
  language     = {eng},
  number       = {1},
  pages        = {15--23},
  publisher    = {Elsevier},
  series       = {Diabetes Research and Clinical Practice},
  title        = {The temporal development of retinopathy and nephropathy in type 1 diabetes mellitus during 15 years diabetes duration},
  url          = {http://dx.doi.org/10.1016/S0168-8227(99)00055-8},
  volume       = {45},
  year         = {1999},
}