To the Editor.—
Dr Sussman et al (1982;247:3231) and Dr Skyler (1982; 247:3246) emphasized the importance and difficulties in diagnosing diabetic retinopathy. Recently, Dr Arlan Rosenbloom et al1 have identified a subgroup of juvenile diabetics—30% with the syndrome of "limited joint mobility" or "joint stiffness"—who may warrant closer watching for the development of retinopathy.For those patients with limited joint mobility, Dr Rosenbloom has estimated an 83% risk of microvascular disease (ie, retinopathy and/or nephropathy) after 16 years of juvenile diabetes. Patients without limited joint mobility have a projected 25% risk of microvascular disease in the same period.
Gandola CD. Limited Joint Mobility and Retinopathy in Juvenile Diabetes. JAMA. 1982;248(16):1975. doi:10.1001/jama.1982.03330160027016
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