Overt albuminuria predicts diabetic retinopathy in Hispanics with NIDDM

Estacio, R.O.; McFarling, Eric T.; Biggerstaff, Stacy L.; Jeffers, Barrett W.; Johnson, Daniel; Rw, Schrier

doi:10.1053/ajkd.1998.v31.pm9631838

Cited by 89 publications

(62 citation statements)

References 20 publications

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“…should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist shortly after the diagnosis of diabetes. B In addition to diabetes duration, factors that increase the risk of, or are associated with, retinopathy include chronic hyperglycemia (42), nephropathy (43), and hypertension (44). Intensive diabetes management with the goal of achieving near-normoglycemia has been shown in large prospective randomized studies to prevent and/or delay the onset and progression of diabetic retinopathy (11,45).…”

Section: Referral To Nephrologistmentioning

confidence: 99%

9. Microvascular Complications and Foot Care

2014

Diabetes Care

108

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Section: Referral To Nephrologistmentioning

confidence: 99%

9. Microvascular Complications and Foot Care

2014

Diabetes Care

108

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“…25,45,52,60,61,[65][66][67]69,70,124,126,141,146,164 Of these, only five were comparative studies between ethnic groups. 52,65,67,69,70 One study reported a similar prevalence in Hispanics and non-Hispanic whites, 52 whereas the remaining four reported differences between blacks, whites, Mexicans, and Hispanics. In the third National Health and Nutrition Examination Survey in the USA, the prevalence of DR was 46% higher in blacks and 84% higher in Mexican Americans than whites with diabetes (Table 5).…”

Section: Ethnic Variationmentioning

confidence: 99%

Epidemiology of diabetic retinopathy and macular oedema: a systematic review

Williams

Airey

Baxter

et al. 2004

Eye

400

243

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Aims To systematically review the literature on the prevalence and incidence of diabetic retinopathy (DR) and macular oedema (MO). Methods A search of the bibliographic databases (Medline, Embase, CINAHL) was conducted up to October 2001. Selected relevant studies were scrutinized and included in the review. Results A total of 359 studies were included. The studies were reported in nearly 100 different journals and in over 50 countries. The majority of the studies were US-based, with large studies such as the Wisconsin Epidemiologic Study of Diabetic Retinopathy dominating the literature. The studies were quite dated and highly heterogeneous in nature in terms of patient selection with variable inclusion criteria (age range, gender, diabetes duration and type, ethnicity, comorbidity, and DR status, assessment, and classification). Conclusions There are inconsistencies between epidemiological studies, and differences in study methods may contribute to conflicting reports of prevalence and incidence of DR and MO in diabetic populations. As new therapies for DR and its associated complications emerge, the need to capture and monitor new epidemiological data becomes increasingly important to be able to assess the impact and effectiveness of these therapies. Robust, longitudinal capture of patient data is, therefore, essential to evaluate the impact of current practice on the epidemiology of diabetic eye complications.

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“…A direct relation between the degree of glycemic control and the incidence and progression of retinopathy and nephropathy has been noted in patients with type 2 diabetes (5,30). Albuminuria was established as a predictor of diabetic retinopathy in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (12) but in a recent study was confirmed in only Hispanic patients (31). The association between the development of diabetic retinopathy and nephropathy suggests common pathogenetic factors that may underlie the development of both complications (32).…”

Section: Research Design Andmentioning

confidence: 99%

Metabolic Control of Diabetes Is Associated With an Improved Response of Diabetic Retinopathy to Panretinal Photocoagulation

Kotoula

Koukoulis²,

Ζιντζαράς³

et al. 2005

Diabetes Care

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OBJECTIVE -To study the influence of glycemic control and the presence of microalbuminuria on the initial response to panretinal photocoagulation (PRP) in patients with a high-risk proliferative diabetic retinopathy (PDR).RESEARCH DESIGN AND METHODS -This was a prospective cohort study with a two-by-two factorial design. We used full-scattered PRP to treat 115 eyes of type 2 diabetic patients who have high-risk PDR. HbA 1c (A1C) and albumin levels in 24-h urine were constantly monitored during the preenrollment, treatment, and posttreatment periods. At a follow-up visit 12 weeks after the last PRP session, the fundus was examined for characteristics of regression from high-risk PDR and the response to PRP was determined to be successful or unsuccessful. The eyes were categorized into four groups based on average A1C levels and the presence or absence of microalbuminuria. The data were analyzed using a logistic regression model. Our statistical analysis determined the probability of achieving a satisfactory response to PRP in association with A1C levels and the presence or absence of microalbuminuria.RESULTS -Of the 115 eyes examined, 65 (56.5%) had a successful initial response to PRP and 50 (43.5%) did not. The probability of a satisfactory response to PRP was related to A1C levels (P Ͻ 0.05) but not to microalbuminuria and its interaction with hemoglobin glycosylation (P Ն 0.05).CONCLUSIONS -Low levels of hemoglobin glycosylation (A1C Ͻ8%) during the pretreatment, treatment, and posttreatment periods are associated with a regression of proliferative diabetic retinopathy after PRP. Diabetes Care 28:2454 -2457, 2005D iabetic retinopathy has been the subject of in-depth study for the last 3 decades, during which time randomized and controlled multicenter clinical trials have provided important information about the natural history and treatment of the disease. Panretinal photocoagulation (PRP) is the treatment of choice for proliferative diabetic retinopathy (PDR) (1). However, some patients do not respond to PRP and eventually experience legal blindness (2).Hyperglycemia is an important risk factor for the development of microvascular disease in diabetic patients. There is a direct relation between the degree of glycemic control and the incidence and progression of retinopathy (3-11). However, the influence of metabolic control of diabetes on the response of diabetic retinopathy to PRP has not been previously studied. Linking PRP effectiveness with metabolic control of diabetes may provide useful information for visual prognosis in diabetic patients.Data from most studies suggest an association between diabetic nephropathy, as manifested by microalbuminuria, and diabetic retinopathy (12). There are no data, however, on whether the presence of microalbuminuria is a negative prognostic factor for the efficacy of PRP. The aim of this study was to assess the influence of the degree of glycemic control and microalbuminuria on the initial response to PRP in patients with high-risk PDR. RESEARCH DESIGN AND METHODS -Thi...

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Overt albuminuria predicts diabetic retinopathy in Hispanics with NIDDM

Cited by 89 publications

References 20 publications

9. Microvascular Complications and Foot Care

9. Microvascular Complications and Foot Care

Epidemiology of diabetic retinopathy and macular oedema: a systematic review

Metabolic Control of Diabetes Is Associated With an Improved Response of Diabetic Retinopathy to Panretinal Photocoagulation

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