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Diabetic Control and Progression of Retinopathy in Elderly Patients: Five‐Year Follow‐up Study
Author(s) -
Morisaki Nobuhiro,
Watanabe Satoe,
Kobayashi Junji,
Kanzaki Tetsuto,
Takahashi Kazuo,
Yokote Koutaro,
Tezuka Mariko,
Tashiro Jun,
Inadera Hidekuni,
Saito Yasushi,
Yoshida Sho,
Shigemura Kentaro
Publication year - 1994
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1994.tb04941.x
Subject(s) - medicine , retinopathy , diabetic retinopathy , diabetes mellitus , body mass index , cohort , surgery , ophthalmology , endocrinology
Objective: To assess whether control of diabetes mellitus is as important in the elderly as in young and middle‐aged diabetic patients in terms of progression of retinopathy. Design: A 5‐year longitudinal cohort study. Setting: Outpatient diabetic clinic. Patients: One hundred fourteen non‐insulin‐dependent diabetic patients (30 males, 84 females) ≥ 60 years of age. Measurements: Retinopathy was checked at the beginning and end of the follow‐up period. During the 5‐year follow‐up period, demographic variables, body mass index, HbA***1c, blood pressure, and plasma lipids were monitored. Retinopathy was classified as follows: grade 0, no lesion; grade 1, non‐proliferative retinopathy; grade 2, pre‐proliferative retinopathy; grade 3, proliferative retinopathy. Progression of retinopathy during the 5‐year follow‐up was defined as an increase in its grade. Results: At the start of the study, 13% of the patients already had retinopathy, all of grade 1. The 5‐year follow‐up study showed that progression of retinopathy was 23.6% in all cases, 22.2% in those with grade 0 initially, and 33.3% in those with grade 1 initially. The progression rates of retinopathy as a function of the mean HbA***1c during the follow‐up were as follows: lower than 7%, 2%; 7–8%, 20%; 8–9%, 40%; more than 9%, 61%. Multiple logistic regression analysis showed that, of the parameters examined, only HbA***1c was a significant risk factor for progression of retinopathy. Conclusions: Control of diabetes mellitus is the most important factor associated with prevention of progression of retinopathy in elderly patients.