[Retinopathy in patients with insulin-dependent diabetes mellitus of short duration].
To evaluate the role of metabolic control at the beginning of insulin-dependent diabetes mellitus (IDDM) in the development of diabetic retinopathy (DR) a cross-sectional study was performed with a retrospective analysis of 24 patients followed for at least seven years. The following parameters were investigated: 1) At IDDM diagnosis, age, sex, metabolic control (basal serum glucose, HbA1, cholesterol, triglycerides) and endogen insulin secretion (EIS). 2) At one year in the follow-up: EIS. 3) Since IDDM diagnosis and every 3-4 months: body mass index, dose and pattern of insulin administration and metabolic control. 4) At seven years in the follow-up: direct ophthalmoscopy, fluorescein angiography, microalbuminuria and blood pressure. In the seventh year of follow-up five patients (23.8%; 95% CI: 8.2%-47.2%) developed changes in fluorescein angiography secondary to IDDM. Compared with patients with normal fluorescein angiography their metabolic control was poorer (mean HbA1--seven years--: 11.7 +/- 0.5 versus 9.8 +/- 0.3%; p = 0.01); mean basal glycemia--seven years--: 214 +/- 13.3 versus 174 +/- 7.7 mg/dl; p = 0.03) and their systolic blood pressure (SBP) higher (124 +/- 5.5 versus 111 +/- 2.8 mmHg; p = 0.04). Logistic regression revealed that mean HbA1 values for seven years was the only independent risk factor significantly associated with the development of DR (p = 0.04). The conclusion is that in patients with IDDM of short duration, the development of DR is associated with a deficient glucose control and a higher SBP.
González-Clemente
J M
JM
Servei d'Endocrinología i Nutrició, Departament de Medicina, Universitat de Barcelona.
Esmatjes
E
E
Adán
A
A
Raitieri
J C
JC
Levy
I
I
Gomis
R
R
Vilardell
E
E
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D003627:Data Interpretation, Statistical; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012307:Risk Factors; D013997:Time Factors
D001786:Blood Glucose
Retinopatía en pacientes con diabetes mellitus dependiente de insulina de corta evolución.