title: Cumulative glycaemia as measured by lens fluorometry: association with retinopathy in type 2 diabetes.
abstract: OBJECTIVE
  The aim of this study was to assess the association between lifelong cumulative glycaemia estimated by lens fluorometry and the presence of retinopathy in individuals with type 2 diabetes.
  
  
  METHODS
  We carried out a cross-sectional population-based study of 970 participants aged between 30 and 60 years, of which 170 were diagnosed with diabetes on screening (WHO 1999 criteria) and 35 had known type 2 diabetes. Procedures included clinical and laboratory examinations, non-invasive assessment of the intrinsic fluorescence of the lens of the eye, and seven-field fundus photography.
  
  
  RESULTS
  Retinopathy was found in 46 (22%) of 205 participants with type 2 diabetes. In a logistic regression analysis controlling for age, sex and diabetes status (screen-detected or known), a two-fold increase in lens fluorescence increased the odds for retinopathy by 3.46 (95% CI 1.25-9.55, p = 0.017). The association was marginally significant (OR 3.00 [95% CI 1.00-9.01], p = 0.050) when also adjusted for smoking, systolic blood pressure, body mass index and HbA(1c).
  
  
  CONCLUSIONS
  Diabetic retinopathy was related to cumulative lifelong glycaemia as estimated by lens fluorometry in participants with type 2 diabetes. This supports the hypothesis that retinopathy is a marker of lifelong elevated glycaemia as well as of the unknown, pre-diagnostic duration of type 2 diabetes. The powerful association between lens fluorescence and retinopathy underscores the importance of strict long-term glycaemic control in the prevention of retinopathy in people with diabetes.
authors.affiliation: Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Nordre Ringvej 59, 2600 Glostrup, Denmark. icm@dadlnet.dk
authors.forename: I C
authors.initials: IC
authors.lastname: Munch
authors.forename: M
authors.initials: M
authors.lastname: Larsen
authors.forename: K
authors.initials: K
authors.lastname: Borch-Johnsen
authors.forename: C
authors.initials: C
authors.lastname: Glümer
authors.forename: H
authors.initials: H
authors.lastname: Lund-Andersen
authors.forename: L
authors.initials: L
authors.lastname: Kessel
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D005470:Fluorometry / Q000379:methods*; D006801:Humans; D007908:Lens, Crystalline / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged