EASDEC European Association for the Study of Diabetic Eye Complications
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EASDEC European Association for the Study of Diabetic Eye Complications |
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Abstract: Lövestam-AdrianTHE DEVELOPMENT OF RETINOPATHY AND NEPHROPATHY DURING 15 YEARS DIABETES DURATION M Lövestam-Adrian, E Agardh and C-D Agardh Department of Ophthalmology, University Hospital, Lund and Department of Endocrinology, University Hospital MAS, Malmö. The incidence and progression of retinopathy in relation to medical risk factors, such as metabolic control, blood pressure, albuminuria and GFR were studied prospectively from 3.1± 1.9 years diabetes duration in 29 patients with type 1 diabetes mellitus treated under routine care. Retinopathy was based on fundus photo grading, classified as no retinopathy, background retinopathy and sight- threatening retinopathy (that is macular-oedema, severe non-proliferative or proliferative retinopathy). The incidence of any retinopathy was 39% after 10 years diabetes duration and 80% after 15 years diabetes duration (76% background and 24% sight-threatening retinopathy). Patients who developed sight-threatening retinopathy had higher mean HbA1c levels than patients without any retinopathy, both after 10 years (8.9± 1.2 vs. 6,6± 1.8%; p<0.05) and after 15 years diabetes duration (9.5± 1.5 vs. 6.9± 1.6%; p<0.05). They also had higher levels of HbA1c than patients with background retinopathy after 15 years diabetes duration (9.5± 1.5 vs.7.8± 1.2%; p<0.05). For all patients, regardless of retinopathy, the metabolic control was improved during the last 10 years (7.8± 1.5 vs.9.7± 2.1%; p<0.001). There were no differences in blood pressure levels between patients who developed retinopathy and those who did not.Two patients developed clinical signs of nephropathy (urinary albumin levels of 320-1590 mg/l) after 12 and 13 years diabetes duration. At those time points, both patients had already developed background retinopathy since two years. In conclusion, the incidence of retinopathy was associated with the duration of diabetes. There was a strong association between the degree of metabolic control and the development of sight-threatening retinopathy but not with background retinopathy. The study also showed that there was no association between the development of retinopathy, hypertension, and clinical signs of nephropathy. |
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