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March 1997

Incidence of Retinopathy and Associated Risk Factors From Time of Diagnosis of Insulin-Dependent Diabetes

Author Affiliations

From the Departments of Ophthalmology and Visual Sciences (Dr Klein) and Preventive Medicine (Drs Palta, Allen, and D'Alessio and Ms Shen), University of Wisconsin Medical School, Madison, and the Department of Ophthalmology, Medical College of Wisconsin, Milwaukee (Dr Han).

Arch Ophthalmol. 1997;115(3):351-356. doi:10.1001/archopht.1997.01100150353007

Objective:  To describe the prevalence at baseline and 4-year incidence of retinopathy and its relation to glycemic control from the time of diagnosis of insulin-dependent diabetes.

Design:  Geographically defined population-based study.

Setting:  Twenty-eight-county area in Wisconsin.

Study Population:  Incipient cohort of children, teenagers, and young adults (n=354) up to 30 years of age with newly diagnosed insulin-dependent diabetes.

Main Outcome Measure:  Diabetic retinopathy as determined by gradings from 30° color stereoscopic photographs of the Diabetic Retinopathy Study 7 standard fields.

Results:  The prevalence of retinopathy at diagnosis was 1.3%. Four years after diagnosis of diabetes, retinopathy was first identified in 5.1% of our cohort and in 9.7% of those 15 years of age or older. After controlling for age, subjects with a mean glycosylated hemoglobin level of 12% or greater were 3.2 times as likely (95% confidence interval, 1.1-9.9) to have retinopathy present at follow-up as were subjects with a mean glycosylated hemoglobin level of less than 12%.

Conclusion:  Population-based data on the frequency and incidence of retinopathy from the time of diagnosis of insulin-dependent diabetes mellitus provided by this study suggest a possible reduction in risk of developing retinopathy in those in whom glycemic control is achieved from the time of diagnosis.