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

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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 < 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.

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Authors
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Endocrinology and Diabetes

Keywords

  • Retinopathy, Nephropathy, Metabolic control, Duration, Routine care, Diabetes mellitus
Original languageEnglish
Pages (from-to)15-23
JournalDiabetes Research and Clinical Practice
Volume45
Issue number1
Publication statusPublished - 1999
Publication categoryResearch
Peer-reviewedYes

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Ophthalmology (Lund) (013043000), Unit on Vascular Diabetic Complications (013241510)