The Natural History of Retinopathy in Insulin-Dependent Juvenile-Onset Diabetes

Palmberg, Paul; Smith, Morton E.; Waltman, Stephen R.; Krupin, Theodore; Singer, Paul; Burgess, Dean B.; Wendtlant, Thomas; Achtenberg, Joel; Cryer, Philip E.; Santiago, Julio V.; White, Neil H.; Kilo, Charles; Daughaday, William H.

doi:10.1016/s0161-6420(81)34975-6

Cited by 189 publications

(82 citation statements)

References 13 publications

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“…PDR is not likely to develop within the first 10 years of diabetes but its incidence reaches about 30 out of 1000 patients per year rapidly afterwards [9,10]. Type II diabetes mellitus can remain unrecognized for years, and this could be why from 7% to as many as 38% of patients already have DR, sometimes STDR, when diabetes is finally diagnosed [11,12].…”

Section: Prevalence and Risk Factorsmentioning

confidence: 99%

Diabetic retinopathy

2002

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Abstract. Easy observation of the fundus oculi makes retinopathy the most frequently reported chronic complication of diabetes and, consequently, the one we know best in terms of epidemiology and natural history. Achieving near-normal levels of blood glucose and blood pressure provides empirical though powerful tools for clinicians to delay the onset and progression of diabetic retinopathy. Even when these measures have failed and retinopathy becomes sight-threatening, laser photocoagulation has proven remarkably effective. Nonetheless, retinopathy remains a leading cause of blindness and there is little evidence that diabetes-related visual loss is decreasing in industrialized countries. This may result from the mixed blessing of prolonged survival of patients who had become diabetic when metabolic control was pursued less fastidiously than today. Screening for sight-threatening retinopathy is the most cost-effective medical procedure known and should help optimise the use of diagnostic and therapeutic resources, but its widest deployment still meets with inertia and lack of interest within most health care systems. Improving clinical skills and technology, however, allow us to take a more optimistic look at the future, as pathogenesis-targeted forms of treatment are being developed and tested through appropriately powered clinical trials. [Diabetologia (2002[Diabetologia ( ) 45:1617[Diabetologia ( -1634

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Section: Prevalence and Risk Factorsmentioning

confidence: 99%

Diabetic retinopathy

2002

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“…The cumulative incidence of PDR of 20 to 40% after 25 years of diabetes duration reported from other studies [8][9][10][11][12][13] is in great contrast to the decline in cumulative incidence reported in cohorts diagnosed after 1970 [12,13]. We could not show any difference in risk of PDR in those diagnosed between 1973 and 1977 compared with those diagnosed between 1978 and 1982, but there is a short time-span between the groups and they were both diagnosed before HbA 1c measurement was introduced.…”

Section: Discussionmentioning

confidence: 88%

“…However, if retinopathy is present, duration of diabetes appears to be a less important factor for the progression from earlier to later stages of retinopathy, but the degree of hyperglycaemia remains important as a risk factor for progression [29]. It has been reported [9,19] that the effect of diabetes duration on the presence of DR is not uniform; in persons who developed diabetes before reaching 13 years of age, duration had less effect than in persons who were 13 years or older at diabetes onset. In our study, when diabetes duration was included in the multivariate models, it was no longer a significant risk factor for development of DR or PDR.…”

Section: Discussionmentioning

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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“…Studies comparing methodologies for diagnosis of diabetic retinopathy are lacking in dogs, but it is reasonable to assume that ophthalmoscopy alone may miss subtle lesions. Although ophthalmoscopy is accepted as the most commonly used screening tool for diabetic retinopathy in humans, fluorescein angiography and multiple field stereoscopic fundus photography are more sensitive than ophthalmoscopy alone in detecting the condition 32, 33. However, neither multiple field stereo fundus photography nor fluorescein angiography is practical to employ on a routine basis with clinical veterinary patients.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Prevalence of Hypertension, Proteinuria, and Retinopathy in Dogs with Spontaneous Diabetes Mellitus

Herring

Panciera

Werre

2014

Veterinary Internal Medicne

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BackgroundThe prevalence and progression of vascular complications of spontaneous diabetes mellitus (DM) in dogs have not been described.ObjectivesTo investigate the effects of duration of disease, as estimated by time since DM diagnosis, and glycemic control on prevalence of systemic hypertension, proteinuria, and diabetic retinopathy in dogs with spontaneous DM.AnimalsSeventeen client‐owned dogs with spontaneous DM.MethodsProspective, longitudinal observational study. Dogs with DM of less than 1 year's duration were recruited and evaluated once every 6 months for 24 months. Recorded measures included indirect BP, urine albumin, protein and creatinine concentrations, serial blood glucose and serum fructosamine concentrations, ophthalmic examination, and a standardized behavioral questionnaire.ResultsEleven dogs completed the 2‐year follow‐up period, during which the highest recorded prevalence of systolic and diastolic hypertension was 55 and 64%, respectively. Prevalence of microalbuminuria and elevated urine protein:creatinine ratio (UPC) ranged up to 73 and 55%, respectively. Prevalence of retinopathy ranged up to 20%. No significant effect of time since DM diagnosis or glycemic control was detected for any of the measures examined. Additionally, no significant associations between BP, urine albumin concentration, UPC and retinopathy were detected.Conclusions and Clinical RelevanceWith the exception of proteinuria, which was substantial in some cases, clinically deleterious diabetic vascular complications were not identified in dogs in this study.

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The Natural History of Retinopathy in Insulin-Dependent Juvenile-Onset Diabetes

Cited by 189 publications

References 13 publications

Diabetic retinopathy

Diabetic retinopathy

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

Longitudinal Prevalence of Hypertension, Proteinuria, and Retinopathy in Dogs with Spontaneous Diabetes Mellitus

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