This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (102)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Diabetic Retinopathy  • Diagnosis  • Alert me on articles by topic

Diabetic Retinopathy at Diagnosis of Non–Insulin-Dependent Diabetes Mellitus and Associated Risk Factors

Eva M. Kohner, MD; Stephen J. Aldington, DMS; Irene M. Stratton, MSc; Susan E. Manley, PhD; Rury R. Holman, MD; David R. Matthews, MD; Robert C. Turner, MD; for the United Kingdom Prospective Diabetes Study

Arch Ophthalmol. 1998;116:297-303.

Objectives  To report on the prevalence of retinopathy in patients with newly diagnosed non–insulin-dependent diabetes mellitus (NIDDM) and to evaluate the relationship of retinopathy to clinical and biochemical variables.

Design  A multicenter, randomized, controlled clinical study of therapy in patients with NIDDM.

Setting and Patients  Patients were part of the United Kingdom Prospective Diabetes Study, a 23-center study of 2964 white patients who had both eyes photographed and assessed.

Outcome Measures  The presence and severity of diabetic retinopathy were evaluated by sex, and the relationship of retinopathy to medical and biochemical parameters was assessed.

Results  Retinopathy, defined as microaneurysms or worse lesions in at least 1 eye, was present in 39% of men and 35% of women. Marked retinopathy with cotton wool spots or intraretinal microvascular abnormalities was present in 8% of men and 4% of women. The severity of retinopathy was related in both sexes to higher fasting plasma glucose levels, higher systolic and diastolic blood pressure, lower serum insulin levels, and reduced -cell function. In addition, in men, increased alcohol consumption was related to increased severity of retinopathy, while leaner women had more severe eye lesions. Visual acuity was normal in most patients, but in men there was a trend for those with more severe retinal lesions to have worse visual acuity.

Conclusions  Diabetic retinopathy is common in patients with newly diagnosed NIDDM. Careful ophthalmic assessment at diagnosis is important.

From the Department of Endocrinology, Diabetes & Metabolic Medicine, St Thomas' Hospital, London, England (Dr Kohner); Retinopathy Grading Centre, Royal Postgraduate Medical School, London (Dr Aldington); and Diabetes Research Laboratories, Radcliffe Infirmary, Oxford, England (Ms Stratton and Drs Manley, Holman, Matthews, and Turner).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The English national screening programme for sight-threatening diabetic retinopathy
Scanlon
J Med Screen 2008;15:1-4.
ABSTRACT | FULL TEXT  

Ocular regeneration by stem cells: present status and future prospects
Limb and Daniels
Br Med Bull 2008;85:47-61.
ABSTRACT | FULL TEXT  

The prevalence and severity of diabetic retinopathy, associated risk factors and vision loss in patients registered with type 2 diabetes in Luganville, Vanuatu
Smith et al.
Br. J. Ophthalmol. 2007;91:415-419.
ABSTRACT | FULL TEXT  

Diabetic Retinopathy: Seeing Beyond Glucose-Induced Microvascular Disease
Antonetti et al.
Diabetes 2006;55:2401-2411.
ABSTRACT | FULL TEXT  

Risk Factors for Renal Dysfunction in Type 2 Diabetes: U.K. Prospective Diabetes Study 74
Retnakaran et al.
Diabetes 2006;55:1832-1839.
ABSTRACT | FULL TEXT  

Prevalence of Diabetic Retinopathy in Urban India: The Chennai Urban Rural Epidemiology Study (CURES) Eye Study, I
Rema et al.
IOVS 2005;46:2328-2333.
ABSTRACT | FULL TEXT  

Serum prorenin levels and diabetic retinopathy in type 2 diabetes: new method to measure serum level of prorenin using antibody activating direct kinetic assay
Yokota et al.
Br. J. Ophthalmol. 2005;89:871-873.
ABSTRACT | FULL TEXT  

The Cost-Effectiveness of Lifestyle Modification or Metformin in Preventing Type 2 Diabetes in Adults with Impaired Glucose Tolerance
Herman et al.
ANN INTERN MED 2005;142:323-332.
ABSTRACT | FULL TEXT  

Predictors of improved glycaemic control with rosiglitazone therapy in type 2 diabetic patients: a practical approach for the primary care physician
Miyazaki et al.
British Journal of Diabetes & Vascular Disease 2005;5:28-35.
ABSTRACT  

Increased Utilization of Primary Care 5 Years Before Diagnosis of Type 2 Diabetes: A matched cohort study
Gulliford et al.
Diabetes Care 2005;28:47-52.
ABSTRACT | FULL TEXT  

The prevention of type 2 diabetes mellitus: recent advances
Younis et al.
QJM 2004;97:451-455.
ABSTRACT | FULL TEXT  

Prevention or Delay of Type 2 Diabetes
Diabetes Care 2004;27:s47-47.
FULL TEXT  

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Chobanian et al.
Hypertension 2003;42:1206-1252.
ABSTRACT | FULL TEXT  

Microvascular Complications at Time of Diagnosis of Type 2 Diabetes Are Similar Among Diabetic Patients Detected by Targeted Screening and Patients Newly Diagnosed in General Practice: The Hoorn Screening Study
Spijkerman et al.
Diabetes Care 2003;26:2604-2608.
ABSTRACT | FULL TEXT  

Screening for diabetic retinopathy
Squirrell and Talbot
JRSM 2003;96:273-276.
FULL TEXT  

The Prevention or Delay of Type 2 Diabetes
Diabetes Care 2003;26:s62-69.
FULL TEXT  

Macular Edema Reflects Generalized Vascular Hyperpermeability in Type 2 Diabetic Patients With Retinopathy
Knudsen et al.
Diabetes Care 2002;25:2328-2334.
ABSTRACT | FULL TEXT  

Blood Pressure, Lipids, and Obesity Are Associated With Retinopathy: The Hoorn Study
van Leiden et al.
Diabetes Care 2002;25:1320-1325.
ABSTRACT | FULL TEXT  

Are Lower Fasting Plasma Glucose Levels at Diagnosis of Type 2 Diabetes Associated With Improved Outcomes?: U.K. Prospective Diabetes Study 61
Colagiuri et al.
Diabetes Care 2002;25:1410-1417.
ABSTRACT | FULL TEXT  

The Prevention or Delay of Type 2 Diabetes
Clin. Diabetes 2002;20:109-116.
FULL TEXT  

The Prevention or Delay of Type 2 Diabetes
Diabetes Spectr. 2002;15:147-157.
FULL TEXT  

A prospective, case controlled study of the natural history of diabetic retinopathy and maculopathy after uncomplicated phacoemulsification cataract surgery in patients with type 2 diabetes
Squirrell et al.
Br. J. Ophthalmol. 2002;86:565-571.
ABSTRACT | FULL TEXT  

The Prevention or Delay of Type 2 Diabetes
American Diabetes Association
Diabetes Care 2002;25:742-749.
FULL TEXT  

Atherosclerotic cardiovascular disease and diabetic retinopathy
Arroyo
Br. J. Ophthalmol. 2002;86:3-4.
FULL TEXT  

Diabetes: Relationship to ischaemic heart disease
Timmis
Br Med Bull 2001;59:159-172.
ABSTRACT | FULL TEXT  

Prevalence of retinopathy at diagnosis among type 2 diabetic patients attending a diabetic centre in south India
Rema et al.
Br. J. Ophthalmol. 2000;84:1058-1060.
ABSTRACT | FULL TEXT  

Treatment of Diabetic Retinopathy
Ferris et al.
NEJM 1999;341:667-678.
FULL TEXT  

Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38
UK Prospective Diabetes Study Group
BMJ 1998;317:703-713.
ABSTRACT | FULL TEXT