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The frequency and severity of retinopathy are related to HbA(1c) values after, but not at, the diagnosis of NIDDM

Henricsson, M. LU ; Gottsäter, A. LU ; Jeppsson, J. O. LU ; Fernlund, P. LU and Sundkvist, G. LU (1998) In Journal of Internal Medicine 244(2). p.149-154
Abstract

Objectives. To examine the relationship between previous glycaemic exposure and prevalence of retinopathy 8 years after diagnosis of diabetes in 58 islet cell antibodies (ICA)-negative noninsulin-dependent diabetes mellitus (NIDDM) patients and in a group of 14 ICA-positive 'NIDDM' and insulin-dependent diabetes mellitus (IDDM) patients. Design and methods. The Wisconsin retinopathy scale was used to assess the retinopathy which was graded into mild, moderate and severe nonproliferative diabetic retinopathy (NPDR), or proliferative retinopathy (PDR). The frequency and severity of retinopathy was related to HbA(1c) levels at diagnosis, and 3 and 5 years later. Results. Thirty of the 58 ICA-negative NIDDM patients (52%) but only 2 of the... (More)

Objectives. To examine the relationship between previous glycaemic exposure and prevalence of retinopathy 8 years after diagnosis of diabetes in 58 islet cell antibodies (ICA)-negative noninsulin-dependent diabetes mellitus (NIDDM) patients and in a group of 14 ICA-positive 'NIDDM' and insulin-dependent diabetes mellitus (IDDM) patients. Design and methods. The Wisconsin retinopathy scale was used to assess the retinopathy which was graded into mild, moderate and severe nonproliferative diabetic retinopathy (NPDR), or proliferative retinopathy (PDR). The frequency and severity of retinopathy was related to HbA(1c) levels at diagnosis, and 3 and 5 years later. Results. Thirty of the 58 ICA-negative NIDDM patients (52%) but only 2 of the 14 ICA-positive 'NIDDM' or IDDM patients (14%) had mild-moderate- severe NPDR 8 years after diagnosis (P = 0.02). None had PDR. Retinopathy 8 years after diagnosis in NIDDM (= 58 ICA-negative patients) was correlated with the degree of glycaemiC control (HbA(1c) levels) at 3 and 5 years after diagnosis, but not to HbA(1c) levels at diagnosis. The relative risk for a higher average HbA(1c) (per percentage) at 3 and 5 years was 1.56 for any retinopathy vs. no retinopathy (95% confidence interval 1.1-2.2; P = 0.01) and 1.68 for moderate to severe NPDR in comparison with no DR and mild NPDR (95% confidence interval 1.0-2.8; P = 0.04). Conclusions. Retinopathy after 8 years of diabetes in NIDDM patients was associated with impaired glycaemic control during previous years but not with glycaemic control at baseline. Good glycaemic control may prevent retinopathy in patients with NIDDM.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Diabetic retinopathy, Glycaemic control, Insulin-dependent diabetes mellitus, Islet cell antibodies, Noninsulin-dependent diabetes mellitus
in
Journal of Internal Medicine
volume
244
issue
2
pages
6 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:10095801
  • scopus:0031880976
ISSN
0954-6820
DOI
10.1046/j.1365-2796.1998.00353.x
language
English
LU publication?
yes
id
e5f992b5-5993-4b54-bed9-ddff7b1eb070
date added to LUP
2020-12-11 14:31:26
date last changed
2024-01-03 00:46:37
@article{e5f992b5-5993-4b54-bed9-ddff7b1eb070,
  abstract     = {{<p>Objectives. To examine the relationship between previous glycaemic exposure and prevalence of retinopathy 8 years after diagnosis of diabetes in 58 islet cell antibodies (ICA)-negative noninsulin-dependent diabetes mellitus (NIDDM) patients and in a group of 14 ICA-positive 'NIDDM' and insulin-dependent diabetes mellitus (IDDM) patients. Design and methods. The Wisconsin retinopathy scale was used to assess the retinopathy which was graded into mild, moderate and severe nonproliferative diabetic retinopathy (NPDR), or proliferative retinopathy (PDR). The frequency and severity of retinopathy was related to HbA(1c) levels at diagnosis, and 3 and 5 years later. Results. Thirty of the 58 ICA-negative NIDDM patients (52%) but only 2 of the 14 ICA-positive 'NIDDM' or IDDM patients (14%) had mild-moderate- severe NPDR 8 years after diagnosis (P = 0.02). None had PDR. Retinopathy 8 years after diagnosis in NIDDM (= 58 ICA-negative patients) was correlated with the degree of glycaemiC control (HbA(1c) levels) at 3 and 5 years after diagnosis, but not to HbA(1c) levels at diagnosis. The relative risk for a higher average HbA(1c) (per percentage) at 3 and 5 years was 1.56 for any retinopathy vs. no retinopathy (95% confidence interval 1.1-2.2; P = 0.01) and 1.68 for moderate to severe NPDR in comparison with no DR and mild NPDR (95% confidence interval 1.0-2.8; P = 0.04). Conclusions. Retinopathy after 8 years of diabetes in NIDDM patients was associated with impaired glycaemic control during previous years but not with glycaemic control at baseline. Good glycaemic control may prevent retinopathy in patients with NIDDM.</p>}},
  author       = {{Henricsson, M. and Gottsäter, A. and Jeppsson, J. O. and Fernlund, P. and Sundkvist, G.}},
  issn         = {{0954-6820}},
  keywords     = {{Diabetic retinopathy; Glycaemic control; Insulin-dependent diabetes mellitus; Islet cell antibodies; Noninsulin-dependent diabetes mellitus}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{149--154}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Internal Medicine}},
  title        = {{The frequency and severity of retinopathy are related to HbA(1c) values after, but not at, the diagnosis of NIDDM}},
  url          = {{http://dx.doi.org/10.1046/j.1365-2796.1998.00353.x}},
  doi          = {{10.1046/j.1365-2796.1998.00353.x}},
  volume       = {{244}},
  year         = {{1998}},
}