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UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis.
Diabetologia 2001; 44(2):156-63D

Abstract

AIMS/HYPOTHESIS

To determine risk factors related to the incidence and progression of diabetic retinopathy over 6 years from diagnosis of Type II (non-insulin-dependent) diabetes mellitus.

METHODS

This report describes 1919 patients from within the United Kingdom Prospective Diabetes Study (UKPDS), with retinal photographs taken at diagnosis and 6 years later and with complete data available. Photographs were centrally graded for lesions of diabetic retinopathy using the modified Early Treatment of Diabetic Retinopathy Study Final scale. Risk factors were assessed after 3 months diet from the time of diagnosis of diabetes. Patients were seen every 3 months in a hospital setting. Biochemical measurements were done by a central laboratory. End points of vitreous haemorrhage and photocagulation were confirmed by independent adjudication of systematically collected clinical data. The main outcome measures were incidence and progression of retinopathy defined as a two-step Early Treatment of Diabetic Retinopathy Study (ETDRS) final scale change.

RESULTS

Of the 1919 patients, 1216 (63 %) had no retinopathy at diagnosis. By 6 years, 22 % of these had developed retinopathy, that is microaneurysms in both eyes or worse. In the 703 (37 %) patients with retinopathy at diagnosis, 29 % progressed by two scale steps or more. Development of retinopathy (incidence) was strongly associated with baseline glycaemia, glycaemic exposure over 6 years, higher blood pressure and with not smoking. In those who already had retinopathy, progression was associated with older age, male sex, hyperglycaemia (as evidenced by a higher HbA1c) and with not smoking.

CONCLUSION/INTERPRETATION

The findings re-emphasise the need for good glycaemic control and assiduous treatment of hypertension if diabetic retinopathy is to be minimised.

Authors+Show Affiliations

Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11270671

Citation

Stratton, I M., et al. "UKPDS 50: Risk Factors for Incidence and Progression of Retinopathy in Type II Diabetes Over 6 Years From Diagnosis." Diabetologia, vol. 44, no. 2, 2001, pp. 156-63.
Stratton IM, Kohner EM, Aldington SJ, et al. UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia. 2001;44(2):156-63.
Stratton, I. M., Kohner, E. M., Aldington, S. J., Turner, R. C., Holman, R. R., Manley, S. E., & Matthews, D. R. (2001). UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia, 44(2), pp. 156-63.
Stratton IM, et al. UKPDS 50: Risk Factors for Incidence and Progression of Retinopathy in Type II Diabetes Over 6 Years From Diagnosis. Diabetologia. 2001;44(2):156-63. PubMed PMID: 11270671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. AU - Stratton,I M, AU - Kohner,E M, AU - Aldington,S J, AU - Turner,R C, AU - Holman,R R, AU - Manley,S E, AU - Matthews,D R, PY - 2001/3/29/pubmed PY - 2001/6/2/medline PY - 2001/3/29/entrez SP - 156 EP - 63 JF - Diabetologia JO - Diabetologia VL - 44 IS - 2 N2 - AIMS/HYPOTHESIS: To determine risk factors related to the incidence and progression of diabetic retinopathy over 6 years from diagnosis of Type II (non-insulin-dependent) diabetes mellitus. METHODS: This report describes 1919 patients from within the United Kingdom Prospective Diabetes Study (UKPDS), with retinal photographs taken at diagnosis and 6 years later and with complete data available. Photographs were centrally graded for lesions of diabetic retinopathy using the modified Early Treatment of Diabetic Retinopathy Study Final scale. Risk factors were assessed after 3 months diet from the time of diagnosis of diabetes. Patients were seen every 3 months in a hospital setting. Biochemical measurements were done by a central laboratory. End points of vitreous haemorrhage and photocagulation were confirmed by independent adjudication of systematically collected clinical data. The main outcome measures were incidence and progression of retinopathy defined as a two-step Early Treatment of Diabetic Retinopathy Study (ETDRS) final scale change. RESULTS: Of the 1919 patients, 1216 (63 %) had no retinopathy at diagnosis. By 6 years, 22 % of these had developed retinopathy, that is microaneurysms in both eyes or worse. In the 703 (37 %) patients with retinopathy at diagnosis, 29 % progressed by two scale steps or more. Development of retinopathy (incidence) was strongly associated with baseline glycaemia, glycaemic exposure over 6 years, higher blood pressure and with not smoking. In those who already had retinopathy, progression was associated with older age, male sex, hyperglycaemia (as evidenced by a higher HbA1c) and with not smoking. CONCLUSION/INTERPRETATION: The findings re-emphasise the need for good glycaemic control and assiduous treatment of hypertension if diabetic retinopathy is to be minimised. SN - 0012-186X UR - https://www.unboundmedicine.com/medline/citation/11270671/UKPDS_50:_risk_factors_for_incidence_and_progression_of_retinopathy_in_Type_II_diabetes_over_6_years_from_diagnosis_ L2 - https://dx.doi.org/10.1007/s001250051594 DB - PRIME DP - Unbound Medicine ER -