Natural history of diabetes mellitus with special reference to age of onset and vascular complications.
Age and sex distribution of diabetics, seasonal incidence of diabetes, grade of hyperglycemia, frequency of vascular complications and daily living conditions were studied of 2771 diabetic patients experienced at five clinics. The cases consisted of 1587 male and 1184 female diabetics. The distribution of age of diabetes onset revealed that males predominate among diabetics but females predominate among child diabetics, and that the precentage of child was extremely low. This pattern was emphasized as characteristic of Japanese diabetic population. Distribution of fasting blood sugar at the diagnosis of diabetes was compared among the age groups of diabetes-onset and the results showed that percentage of the value exceeding 300 mg/100 ml was highest in the under 10 year-onset cases and decreased with age. The frequency of diabetic retinopathy and of ischemic ECG changes was analysed from the view point of age of diabetes onset and also the duration of the disease. The frequency of the retinopathy at the diabetes-onset was zero in the under 10 year-onset cases, 4.2% in the 10s-onset cases and increased with age. The longer the duration of the disease the higher the frequency of the retinopathy was. This increase along with the duration was most remarkable in the 10s- and 20s-onset cases and less remarkable in the 30s-onset cases. The retinopathy was significantly more frequent in female diabetics. Daily of the patients were studied by a questionnaire and the analysis of 1022 cases with diabetes of more than three years revealed that cases of patients working uneventfully and/or feeling fit were most frequent among the 30s- or 40s-onset cases and that cases of bed-disability were frequent among the cases whose diabetes was found in their twenties or younger. This study showed that the prognosis of the patients is quite different according to whether their diabetes occurred before of after 30 years of age.
D000041:Absenteeism; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003327:Coronary Disease / Q000209:etiology; D048909:Diabetes Complications; D003925:Diabetic Angiopathies; D003930:Diabetic Retinopathy / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012621:Seasons; D012744:Sex Ratio