[Diabetic retinopathy: twelve-year incidence and progression].
BACKGROUND
Diabetic retinopathy (DR) it is the main cause of preventable blindness in productive-age adults. The rate of progression to blindness from DR differs among countries and populations.


METHODS
In order to report the incidence and progression of DR after 12 years of follow-up in a cohort (n = 100) of adult patients with diabetes mellitus type 2 (DM2) in Leon, Guanajuato, Mexico, we designed an open population cohort study from April 1992 to July 2004. Main variables studied longitudinally were incidence and progression of DR, fasting blood glucose, glycated hemoglobin and associated clinical parameters.


RESULTS
Mean age was 54 +/- (SD) 9.2 years and the time since DM2 diagnosis was 9 +/- 6 years. Incidence rates at 3, 6 and 12 years were 23, 48 and 71%, respectively; and for progression were 56, 70 and 74%, respectively. The 12-year proliferative DR incidence and progression were 14.3 and 32%, respectively. Mean fasting blood glucose levels were 193 mg/dL and for glycated hemoglobin 11%. Mortality was 45%, half attributable to acute myocardial infarction.


CONCLUSIONS
Diabetic retinopathy in our population has a high incidence that doubled in 3 years, and has an accelerated progression toward more severe forms. Incidence and progression are higher than that reported in white non-Hispanics. It should be high priority in our country to (a) prevent diabetes mellitus, (b) improve its metabolic control, (c) establish RD diagnostic programs and (d) give appropriate treatment.
Rodríguez-Villalobos
Elvia
E
Grupo de Estudios Epidemiológicos de la Retinopatía Diabética. rodriguezvillalobos@yahoo.com.mx
Cervantes-Aguayo
Fernando
F
Vargas-Salado
Enrique
E
Avalos-Muñoz
María Elena
ME
Juárez-Becerril
Dulce María
DM
Ramírez-Barba
Ector Jaime
EJ
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000401:mortality; D003930:Diabetic Retinopathy / Q000097:blood / Q000453:epidemiology* / Q000401:mortality; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D013997:Time Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin