ELEVATED LONG-TERM GLYCATED HEMOGLOBIN PRECEDES PROLIFERATIVE RETINOPATHY AND NEPHROPATHY IN TYPE-1 (INSULIN-DEPENDENT) DIABETIC-PATIENTS

被引:30
作者
KULLBERG, CE [1 ]
ARNQVIST, HJ [1 ]
机构
[1] LINKOPING UNIV, FAC HLTH SCI, DEPT INTERNAL MED, S-58183 LINKOPING, SWEDEN
关键词
TYPE-1 (INSULIN-DEPENDENT) DIABETES-MELLITUS; GLYCEMIC CONTROL; DIABETIC RETINOPATHY; DIABETIC NEPHROPATHY;
D O I
10.1007/BF02374480
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The importance of glycaemic control for the development of proliferative retinopathy and nephropathy was assessed by monitoring glycated haemoglobin for 5 years or more before the diagnosis of these complications. The study comprised Type 1 (insulin-dependent) diabetic patients diagnosed at an age less than 31 years, and with diabetes duration 25 years or less. They were followed for an average of 7.9 years with 3.3 measurements per year. Of 172 patients screened for retinopathy 60 had no retinopathy, 104 had background retinopathy, and 8 had proliferative retinopathy. The mean HbA1c (95 % confidence intervals) of the groups was 6.4 % (6.2-6.7 %), 7.3 % (7.1-7.5 %) and 8.9 % (8.1-9.6 %), respectively (p < 0.0001); the mean duration of diabetes was 12, 18, and 17 years. Of 186 patients 7 had nephropathy (albuminuria > 200 mg/1). Mean HbA1c, in patients without nephropathy was 7.0 % (6.8-7.1 %) and in patients with nephropathy 8.8 % (7.8-9.9 %, p < 0.001). Mean diabetes duration was 16 years in both groups. Multiple logistic regression including mean HbA1c, age at onset, duration, sex, and hypertension, was for both proliferative retinopathy and nephropathy significant only for mean HbA1c. In all cases, proliferative retinopathy and nephropathy were preceded by poor glycaemic control over several years, suggesting that these complications are caused by poor glycaemic control.
引用
收藏
页码:961 / 965
页数:5
相关论文
共 28 条
[1]  
[Anonymous], 1981, INVEST OPHTHALMOL VI, V21, P210
[2]  
BOJESTIG M, 1992, ACTA ENDOCRINOL S3, V126, P10
[3]   BLOOD-GLUCOSE CONCENTRATIONS AND PROGRESSION OF DIABETIC-RETINOPATHY - THE 7 YEAR RESULTS OF THE OSLO STUDY [J].
BRINCHMANNHANSEN, O ;
DAHLJORGENSEN, K ;
SANDVIK, L ;
HANSSEN, KF .
BRITISH MEDICAL JOURNAL, 1992, 304 (6818) :19-22
[4]   GLYCATION PRODUCTS AND THE PATHOGENESIS OF DIABETIC COMPLICATIONS [J].
BROWNLEE, M .
DIABETES CARE, 1992, 15 (12) :1835-1843
[5]   GLUCOSE CONTROL AND THE RENAL AND RETINAL COMPLICATIONS OF INSULIN-DEPENDENT DIABETES [J].
CHASE, HP ;
JACKSON, WE ;
HOOPS, SL ;
COCKERHAM, RS ;
ARCHER, PG ;
OBRIEN, D .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1989, 261 (08) :1155-1160
[6]  
Cochran W.G, 1957, STAT METHODS, V6th ed
[7]  
DAVIS MD, 1969, USPHS PUBLICATION, V1890, P7
[8]   NATURAL-HISTORY OF DIABETIC COMPLICATIONS - EARLY DETECTION AND PROGRESSION [J].
DECKERT, T ;
FELDTRASMUSSEN, B ;
BORCHJOHNSEN, K ;
JENSEN, T ;
KOFOEDENEVOLDSEN, A ;
MATHIESEN, ER .
DIABETIC MEDICINE, 1991, 8 :S33-S37
[9]   EFFECT OF IMPROVED METABOLIC CONTROL ON LOSS OF KIDNEY-FUNCTION IN TYPE-1 (INSULIN-DEPENDENT) DIABETIC-PATIENTS - AN UPDATE OF THE STENO STUDIES [J].
FELDTRASMUSSEN, B ;
MATHIESEN, ER ;
JENSEN, T ;
LAURITZEN, T ;
DECKERT, T .
DIABETOLOGIA, 1991, 34 (03) :164-170
[10]   GLYCOSYLATED HEMOGLOBINS AND LONG-TERM BLOOD-GLUCOSE CONTROL IN DIABETES-MELLITUS [J].
GABBAY, KH ;
HASTY, K ;
BRESLOW, JL ;
ELLISON, RC ;
BUNN, HF ;
GALLOP, PM .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1977, 44 (05) :859-864