Prevalence of retinopathy differs with age at onset of diabetes in a population of patients with Type 1 diabetes

Diabet Med. 2002 Nov;19(11):924-31. doi: 10.1046/j.1464-5491.2002.00839.x.

Abstract

Aim: The VISS study (Vascular complications in South-east Sweden) investigates prevalence and incidence of vascular complications in a population with Type 1 diabetes, from a well-defined geographical area and followed from diagnosis with HbA1c measurement.

Method: The study population comprised all 440 patients with Type 1 diabetes onset before the age of 36 years, onset during 1983-1987, and at the time of onset living within the counties of Jönköping, Kalmar or Ostergötland. Retinopathy was examined with fundus photography 1994-1995, and classified according to a modified Airlie House protocol.

Results: Fundus photographs from 390 patients were evaluated. In 277 (71%) patients no retinopathy was seen. The prevalence of retinopathy increased from 11% among patients < 5 years old at diabetes onset, to 48% among those 15-19 years old at diabetes onset, and then decreased to 30% for patients 30-35 years old at diabetes onset (P for chi2 for linear trend for all ages 0.017, for age at onset 0-19 years P = 0.0003), without corresponding differences in duration or HbA1c between patients with different onset age. Patients with HbA1c in the highest quartile (> 8.3% HbA1c) had a relative risk of 2.4 (95% confidence interval (CI) 1.7-3.2) of having any retinopathy compared with patients with lower HbA1c, and a relative risk of 7.1 (95% CI 3.0-16.7) of having other forms of retinopathy than microaneurysms.

Conclusion: In patients with diabetes duration of 6-13 years, the prevalence of retinopathy is clearly related to glycaemic control. Furthermore, the risk of retinopathy varies with different age at onset, independently of differences in duration or glycaemic control.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Child
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetic Retinopathy / blood
  • Diabetic Retinopathy / epidemiology*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Prevalence
  • Regression Analysis
  • Risk Factors
  • Sweden / epidemiology

Substances

  • Glycated Hemoglobin A