Incidence of retinopathy and associated risk factors from time of diagnosis of insulin-dependent diabetes
R. Klein, M. Palta, C. Allen, G. Shen, D. P. Han and D. J. D'Alessio
Department of Ophthalmology, University of Wisconsin Medical School, Madison, USA.
OBJECTIVE: To describe the prevalence at baseline and 4-year incidence of
retinopathy and its relation to glycemic control from the time of diagnosis
of insulin-dependent diabetes. DESIGN: Geographically defined
population-based study. SETTING: Twenty-eight-county area in Wisconsin.
STUDY POPULATION: Incipient cohort of children, teenagers, and young adults
(n = 354) up to 30 years of age with newly diagnosed insulin-dependent
diabetes. MAIN OUTCOME MEASURE: Diabetic retinopathy as determined by
gradings from 30 degrees color stereoscopic photographs of the Diabetic
Retinopathy Study 7 standard fields. RESULTS: The prevalence of retinopathy
at diagnosis was 1.3%. Four years after diagnosis of diabetes, retinopathy
was first identified in 5.1% of our cohort and in 9.7% of those 15 years of
age or older. After controlling for age, subjects with a mean glycosylated
hemoglobin level of 12% or greater were 3.2 times as likely (95% confidence
interval, 1.1-9.9) to have retinopathy present at follow-up as were
subjects with a mean glycosylated hemoglobin level of less than 12%.
CONCLUSION: Population-based data on the frequency and incidence of
retinopathy from the time of diagnosis of insulin-dependent diabetes
mellitus provided by this study suggest a possible reduction in risk of
developing retinopathy in those in whom glycemic control is achieved from
the time of diagnosis.
