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II. Prevalence and Risk of Diabetic Retinopathy When Age at Diagnosis Is Less Than 30 Years

Ronald Klein, MD; Barbara E. K. Klein, MD; Scot E. Moss, MA; Matthew D. Davis, MD; David L. DeMets, PhD

Arch Ophthalmol. 1984;102(4):520-526.

Abstract
• In a population-based study in southern Wisconsin, 996 insulin-taking, younger-onset diabetic persons were examined using standard protocols to determine the prevalence and severity of diabetic retinopathy and associated risk variables. The prevalence of diabetic retinopathy varied from 17% to 97.5% in persons with diabetes for less than five years and 15 or more years, respectively. Proliferative retinopathy varied from 1.2% to 67% in persons with diabetes for less than ten years and 35 or more years, respectively. For persons with diabetes of 10 years' duration or less, the Cox regression model relates the severity of retinopathy to longer duration, older age at examination, and higher levels of glycosylated hemoglobin. After ten years of diabetes, severity of retinopathy was related to longer duration, high levels of glycosylated hemoglobin, presence of proteinuria. higher diastolic BP, and male sex.

Author Affiliations
From the Departments of Ophthalmology (Drs R. Klein, B. Klein, and Davis and Mr Moss) and Statistics (Dr DeMets), University of Wisconsin Medical School, Madison.

Footnotes
Accepted for publication Sept 1, 1983.

Reprint requests to Department of Ophthalmology, Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792 (Dr Klein).

This work was supported by grant EY03083 (Dr R. Klein) from the National Eye Institute. Determinations of glycosylated hemoglobin levels were performed in the Core Laboratory of the Clinical Nutrition Center with support from US Public Health Service, National Institutes of Health grant P30 AM AG 26659 (Earl Shrago, MD).

The authors are grateful to the 452 Wisconsin physicians and their staffs who participated in and supported this study: Frederick Goetz, MD, Don Detmer, MD, Frank Larson, MD, Robin Ewart, MD, Edward Ehrlich, MD, Sigurd Sivertson, MD, Anastosios Tsiatis, PhD, Charles Palit, PhD, and Jean Espenshade, RN, provided consultation and criticism at different stages of the project; Moneen M. Meuer was project coordinator; Stacy Meuer performed data management; Steven D. Kessler, OD, and Karen A. Hasenfuss examined participants; Bob E. Harrison, Michael W. Neider, Dan Mattson, and Marlene Wahlstrom, RN, assisted with fundus photography; Rose Brothers, Magnus Harding, Cheryl Hiner, Yvonne Magli, Mary Peckham, and Anita Temple performed detailed grading of the fundus photographs; Anik Ganguly, BE, Dennis Cudia, PhD, and Larry Hubbard, MA, did programming and gave data management advice; Sue Anderson, MA, and Alasdair MacCormick, PhD, provided statistical consultation; Kathy Kaap, MFA, Bernadette Bull, Jenny Phillips, Sue Thomas, Mae Wildt, and Lorraine Boyle provided secretarial assistance; Jeanne M. Parus, MS, Terry Spennetta, and Dr Shrago, provided laboratory support; Ed Krill, JD, provided legal advice; William Davis, MA, and Reggie Gauger provided administrative support; local hospitals and churches provided supportive services for the mobile examining van; the State of Wisconsin Division of Health donated the van, and Otto Adams drove the van.

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