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Article
November 18, 1988

Glycosylated Hemoglobin Predicts the Incidence and Progression of Diabetic Retinopathy

Author Affiliations

From the Departments of Ophthalmology (Drs R. Klein, B. Klein, and Davis and Mr Moss) and Statistics (Dr DeMets), University of Wisconsin Medical School, Madison.

From the Departments of Ophthalmology (Drs R. Klein, B. Klein, and Davis and Mr Moss) and Statistics (Dr DeMets), University of Wisconsin Medical School, Madison.

JAMA. 1988;260(19):2864-2871. doi:10.1001/jama.1988.03410190112033
Abstract

The relationship between hyperglycemia, measured by glycosylated hemoglobin at the initial examination, and the four-year incidence and progression of diabetic retinopathy was examined in a population-based study in Wisconsin. Younger- (n = 891) and older-onset (n = 987) persons participating in baseline and follow-up examinations were included. Glycosylated hemoglobin was measured by microcolumn. Retinopathy was determined from stereoscopic fundus photographs. In the younger-onset group, comparing the highest with the lowest quartile of glycosylated hemoglobin, the relative risk for developing any diabetic retinopathy was 1.9; for proliferative retinopathy, 21.8; and for progression, 4.0. Among older-onset persons taking insulin, the corresponding relative risks were 1.9, 4.0, and 2.1. Among older-onset persons not taking insulin, relative risks were 4.0 for any retinopathy and 6.2 for progression. A positive relationship between incidence and progression of retinopathy and glycosylated hemoglobin remained after controlling for duration of diabetes, age, sex, and baseline retinopathy. These data suggest a strong and consistent relationship between hyperglycemia and incidence and progression of retinopathy.

(JAMA 1988;260:2864-2871)

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