GOOD BLOOD-GLUCOSE CONTROL CHARACTERIZES PATIENTS WITHOUT RETINOPATHY AFTER LONG DIABETES DURATION

被引：10

作者：

KULLBERG, CE

ARNQVIST, HJ

机构：

[1] Department of Internal Medicine, University Hospital, Linköping

来源：

DIABETIC MEDICINE | 1995年 / 12卷 / 04期

关键词：

TYPE 1 DIABETES MELLITUS; BLOOD GLUCOSE CONTROL; DIABETIC RETINOPATHY;

D O I：

10.1111/j.1464-5491.1995.tb00484.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The importance of blood glucose control for the avoidance of retinopathy was assessed by monitoring glycated haemoglobin for 5 years or more in Type 1 (insulin-dependent) diabetic patients diagnosed before an age of 31 years, and with a diabetes duration of 20 years or more. They were followed up for an average of 9.4 years with 3.3 measurements per year. Of the 213 included patients, 16 had no retinopathy, 126 had background retinopathy (including 8 with macula oedema) and 71 had proliferative retinopathy. Patients without retinopathy had a mean HbA(1c) +/- SEM for the whole follow-up period of 6.3 +/- 0.19 %, the 117 patients with background retinopathy but not macula oedema 7.0 +/- 0.08 %; Mann-Whitney test vs group without retinopathy p = 0.003, macula oedema 7.9 +/- 0.31 %; p = 0.001, and proliferative retinopathy 7.4 +/- 0.09; p < 0.001. The mean duration was 31 years, without significant differences between the groups. In conclusion, these results suggests that good blood glucose control is of major importance to prevent or postpone diabetic retinopathy also after long duration of diabetes, and that no patient with high HbA(1c) levels for several years is protected from retinopathic lesions.

引用

页码：314 / 320

页数：7

共 24 条

[1]

Reichard P., Nilsson BY, Rosenqvist U., The effect of long‐term intensified conventional insulin treatment on the development of microvascular complications of diabetes mellitus, N Engl J Med, 329, pp. 304-309, (1993)

[2]

The effect of intensive treatment of diabetes on the development and progression of long‐term complications in insulin‐dependent diabetes mellitus, N Engl J Med, 329, pp. 977-986, (1993)

[3]

Brinchmann-Hansen O., Dahl-Jorgensen K., Sandvik L., Hanssen KF, Blood glucose concentrations and progression of diabetic retinopathy: the seven year results of the Oslo study, BMJ, 304, pp. 19-22, (1992)

[4]

Feldt-Rasmussen B., Mathiesen ER, Jensen T., Lauritzen T., Deckert T., Effect of improved metabolic control on loss of kidney function in Type 1 (insulin‐dependent) diabetic patients: an update of the Steno studies, Diabetologia, 34, pp. 164-170, (1991)

[5]

Kullberg CE, Arnqvist HJ, Elevated long‐term glycated haemoglobin precedes proliferative retinopathy and nephropathy in Type‐1 (insulin‐dependent) diabetic patients, Diabetologia, 36, pp. 961-965, (1993)

[6]

Orchard TJ, Dorman JS, Maser RE, Becker DJ, Ellis D., LaPorte RE, Et al., Factors associated with avoidance of severe complications after 25 yr of IDDM. Pittsburgh epidemiology of diabetes complications study I, Diabetes Care, 13, pp. 741-747, (1990)

[7]

Orchard TJ, Dorman JS, Maser RE, Becker DJ, Drash AL, Ellis D., Et al., Prevalence of complications in IDDM by sex and duration. Pittsburgh epidemiology of diabetes complications study II, Diabetes, 39, pp. 1116-1124, (1990)

[8]

Krolewski AS, Warram JH, Rand LI, Christlieb AR, Busick EJ, Kahn CR, Risk of proliferative diabetic retinopathy in juvenile‐onset type I diabetes: a 40‐yr follow‐up study, Diabetes Care, 9, pp. 443-452, (1986)

[9]

Klein R., Klein BEK, Moss SE, Davis MD, DeMets DL, The Wisconsin epidemiological study of diabetic retinopathy II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years, Arch Ophthalmol, 102, pp. 520-526, (1984)

[10]

Goldstein DE, Blinder KJ, Ide CH, Wilson RJ, Wiedmeyer HM, Little RR, Et al., Glycemic control and development of retinopathy in youth‐onset insulin‐dependent diabetes mellitus, Ophthalmology, 100, pp. 1125-1132, (1993)

← 1 2 3 →