Diabetes Mellitus and Its Degenerative Complications: A Prospective Study of 4,400 Patients Observed Between 1947 and 1973

Pirart, J.

doi:10.2337/diacare.1.4.252

Cited by 345 publications

(201 citation statements)

References 10 publications

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“…The strong association between HbA 1c and the appearance and progression of retinopathy has been observed in many studies based on clinical patient groups [18,26,27]. The Wisconsin Epidemiological Study of Diabetic Retinopathy [14,28] showed the predictive importance of HbA 1c in a population-based, prospective study.…”

Section: Discussionmentioning

confidence: 96%

“…2). Mean age at diagnosis of PDR was 27 years (range: 17-41), and mean diabetes duration was 19 years (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). Thirty-two patients (10.9%) had no retinopathy at follow-up.…”

Section: Characteristics Of Study Groupmentioning

confidence: 99%

“…Numerous studies [8,[11][12][13][14][15][16][17][18][19][20] have described the prevalence and incidence of DR in type 1 diabetes and its relationship to various characteristics. However, only a few population-based studies of retinopathy in subjects with childhood-onset type 1 diabetes are available [13,15,19,20].…”

Section: Introductionmentioning

confidence: 99%

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Low cumulative incidence of proliferative retinopathy in childhood-onset type 1 diabetes: a 24-year follow-up study

et al. 2006

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Section: Discussionmentioning

confidence: 96%

Section: Characteristics Of Study Groupmentioning

confidence: 99%

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Low cumulative incidence of proliferative retinopathy in childhood-onset type 1 diabetes: a 24-year follow-up study

et al. 2006

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“…Keen et al: Appearance and progression of retinopathy S 28 (u of c) = units of change * p < 0.05; ** p < 0.01; a 0-female, 1-male; b 0 = no, 1 = yes; c 0 = Type II, 1 = Type I diabetes The strong association between degree of hyperglycaemia and the appearance and progression of retinopathy has been observed in many studies based on clinical patient groups, particularly since the introduction of glycated haemoglobin as a measure of glycaemic control [22,23,38,42,46,48]. The Wisconsin Epidemiologic Study of Diabetic Retinopathy [39,43] showed the predictive importance of HbA 1 c in a population-based, prospective study in the United States.…”

Section: Discussionmentioning

confidence: 99%

The appearance of retinopathy and progression to proliferative retinopathy: the WHO multinational study of vascular disease in diabetes

et al. 2001

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Aims/hypothesis. We aimed to estimate incidences of any retinopathy and proliferative diabetic retinopathy (PDR) by direct ophthalmoscopy and relate them to baseline risk factors in re-examined diabetic survivors from 10 centres of the WHO Multinational Study of Vascular Disease in Diabetes. Methods. After a mean follow-up of 8.4 years (11.7 years in Oklahoma), 2877 (71.6 %) survivors were resubmitted to standardised direct ophthalmoscopy as at baseline. The presence of any retinopathy and PDR were recorded at each centre and their incidence estimated in those without retinopathy and PDR at baseline. The independent associations of these incidences with baseline risk factors are expressed as odds ratios derived from multiple logistic regression analyses, within individual centres (which included fasting plasma glucose in 8 and triglyceride in 5) and in pooled data. Results. Of the 4662 original patients, 465 (10.4 %) of those without and 77 (43.0 %) of those with baseline PDR had died (p < 0.001). Any retinopathy was newly reported at follow-up in 47.7 % and PDR in 9.7 % of those free of them at baseline, with reported incidences varying substantially among centres. Incident retinopathy appeared earlier in the known course of diabetes but incidence rates rose more slowly with duration in patients with Type II (non-insulin-dependent) diabetes mellitus than in those with Type I (insulin-dependent) diabetes mellitus. In pooled data and in some individual centres, any retinopathy incidence gave significantly positive odds ratios with age, diabetes duration, systolic pressure, plasma cholesterol, BMI, insulin treatment and proteinuria, and with fasting plasma glucose in the centres where it was measured. Positive odds ratios for PDR were similarly obtained for age, duration, insulin treatment, cholesterol, proteinuria and fasting glycaemia. Smoking status odds ratios were negative for both outcomes. Conclusion/interpretation. Incidence of ophthalmoscopically ascertained any retinopathy varied about twofold and of PDR about threefold among centres. Although, in part attributable to differences between observers, variation in incidence in all centres and in some cases within centres was associated with a number of baseline risk factors. Such associations are not likely due to observer variation or selection biases and emerged despite the imprecision of clinical ophthalmoscopy. Improved detection and control of these risk factors should reduce the impact of diabetic retinopathy and its consequences. [Diabetologia (2001)

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“…However, tubular reabsorption of glucose was not significantly higher in the patients with nephropathy compared with the control group. Pirart [6] and others [18] have shown that good metabolic control of diabetes seems to protect against the development of diabetic nephropathy. In accordance with this, we found that the control group had significantly fewer episodes of ketoacidosis during the first 20 years of diabetes than the nephropathy group.…”

Section: Discussionmentioning

confidence: 99%

Diabetic nephropathy: Fault or destiny?

Deckert¹,

Poulsen²

1981

Diabetologia

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Summary. Twenty-one young onset Type 1 (insulin dependent) diabetics who developed severe diabetic nephropathy after 14.5+3.3 years (mean + SD) and 21 age and sex matched Type 1 diabetics without evidence of nephropathy after more than 32 years of disease were compared with particular reference to body build, insulin requirements, stability of diabetes, heart rate and blood pressure before the development of nephropathy. Attempts were made to evaluate the quality of metabolic control during the first 20 years of diabetes from more than 1,600 out-patient measurements of blood and urinary glucose in each group. The renal tubular reabsorption capacity for glucose was calculated in both groups. No differences between the two groups were found for any of the parameters examined, except that the frequency of ketoacidosis was higher in the patients who developed nephropathy. It is concluded that many Type 1 diabetics seem to be protected against the deleterious effect of diabetes on the kidney. The nature of the protecting factors is unknown.

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Diabetes Mellitus and Its Degenerative Complications: A Prospective Study of 4,400 Patients Observed Between 1947 and 1973

Cited by 345 publications

References 10 publications

Low cumulative incidence of proliferative retinopathy in childhood-onset type 1 diabetes: a 24-year follow-up study

Low cumulative incidence of proliferative retinopathy in childhood-onset type 1 diabetes: a 24-year follow-up study

The appearance of retinopathy and progression to proliferative retinopathy: the WHO multinational study of vascular disease in diabetes

Diabetic nephropathy: Fault or destiny?

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