Lower-than-expected prevalence and severity of retinopathy in an incident cohort followed during the First 4-14 Years of Type 1 diabetes : The wisconsin diabetes registry study

• Published in: American journal of epidemiology Vol. 164; no. 2; pp. 143 - 150
• Main Authors: LECAIRE, Tamara, PALTA, Mari, HONGLING ZHANG, ALLEN, Catherine, KLEIN, Ronald, D'ALESSIO, Donn
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15-07-2006; Oxford Publishing Limited (England)
• Subjects: Adolescent; Analysis. Health state; Biological and medical sciences; Child; Diabetes; Diabetes Mellitus, Type 1 - epidemiology; Diabetic Retinopathy - epidemiology; Diabetic Retinopathy - pathology; Epidemiology; Female; General aspects; Glycated Hemoglobin A - analysis; Humans; Incidence; Inflammatory diseases; Linear Models; Longitudinal Studies; Male; Medical sciences; Miscellaneous; Ophthalmology; Prevalence; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries; Retina; Retinopathies; Risk Factors; Severity of Illness Index; Wisconsin - epidemiology; United States; North America; Wisconsin; America; United States > US; Endocrinopathy; Human; type 1; diabetic retinopathy; longitudinal studies; risk factors; Immunopathology; Statistical analysis; Prevalence; Retinopathy; Cardiovascular disease; Autoimmune disease; diabetes mellitus; Epidemiology; Vascular disease; Eye disease; Microangiopathy; Type 1 diabetes; Follow up study; Cohort study; Specific registry; Risk factor; Complication; Public health
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwj166

The authors examined the development of diabetic retinopathy in a population-based cohort of persons with incident type 1 diabetes to investigate the possibility of lowered retinopathy prevalence and severity compared with previous US studies. A total of 474 diabetic persons from Wisconsin were followed from diagnosis through 4-14 years' duration during 1990-2002. Retinopathy was determined by fundus photography at 4, 7, 9, and 14 years' duration. Risk of developing retinopathy was modeled on demographic and diabetes-care characteristics by means of a generalized linear model using the complementary log-log link for interval-censored data. Prevalence of retinopathy increased with duration of diabetes, from 6% at 4 years to 73% at 14 years, and was highest among adults (> or =20 years of age). Risk of developing retinopathy increased with increasing duration, worse glycemic control, and age up to 20 years. Indicators of diabetes care were related to retinopathy through their effect on glycemic control. Improvements in diabetes care leading to better glycemic control may have contributed to the much lower prevalence and less severe retinopathy observed than expected on the basis of a previous report from the same region of Wisconsin. The observed decreased prevalence has important implications for persons with type 1 diabetes, since retinopathy is a serious microvascular complication.