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Prevalence of retinopathy differs with age at onset of diabetes in a population of patients with Type 1 diabetes
Author(s) -
Kullberg C. E.,
Abrahamsson M.,
Arnqvist H. J.,
Finnström K.,
Ludvigsson J.
Publication year - 2002
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2002.00839.x
Subject(s) - medicine , retinopathy , diabetic retinopathy , diabetes mellitus , fundus photography , population , quartile , type 2 diabetes , fundus (uterus) , incidence (geometry) , age of onset , relative risk , confidence interval , pediatrics , surgery , fluorescein angiography , visual acuity , endocrinology , disease , physics , environmental health , optics
Aim The VISS study (Vascular complications in South‐east Sweden) investigates prevalence and incidence of vascular complications in a population with Type 1 diabetes, from a well‐defined geographical area and followed from diagnosis with HbA 1c measurement. Method The study population comprised all 440 patients with Type 1 diabetes onset before the age of 36 years, onset during 1983–1987, and at the time of onset living within the counties of Jönköping, Kalmar or Östergötland. Retinopathy was examined with fundus photography 1994–1995, and classified according to a modified Airlie House protocol. Results Fundus photographs from 390 patients were evaluated. In 277 (71%) patients no retinopathy was seen. The prevalence of retinopathy increased from 11% among patients < 5 years old at diabetes onset, to 48% among those 15–19 years old at diabetes onset, and then decreased to 30% for patients 30–35 years old at diabetes onset ( P for χ 2 for linear trend for all ages 0.017, for age at onset 0–19 years P = 0.0003), without corresponding differences in duration or HbA 1c between patients with different onset age. Patients with HbA 1c in the highest quartile (> 8.3% HbA 1c ) had a relative risk of 2.4 (95% confidence interval (CI) 1.7–3.2) of having any retinopathy compared with patients with lower HbA 1c , and a relative risk of 7.1 (95% CI 3.0–16.7) of having other forms of retinopathy than microaneurysms. Conclusion In patients with diabetes duration of 6–13 years, the prevalence of retinopathy is clearly related to glycaemic control. Furthermore, the risk of retinopathy varies with different age at onset, independently of differences in duration or glycaemic control. Diabet. Med. 19, 924–931 (2002)