Prevalence Of Proliferative Diabetic Retinopathy Research Articles

The prevalence of diabetic retinopathy in northwest Spain. An epidemiological study of diabetic retinopathy in Galicia. I.

The prevalence of retinopathy was studied in a group of 1179 diabetic patients attending 11 diabetologic centres in Gallica (Northwest of Spain). The age of the patients was 61.7 +/- 13.8 years, 43.8% were males and 56.2% females. The patients had had diabetes from 8.4 +/- 7.5 years, 30.4% were being treated with insulin, and 69.6% with oral antihyperglycaemics. 16.1% were aged under 40 years at onset as against 83.9% aged over 40 years. The prevalence of retinopathy was 44.7, in the whole group. Stepwise multiple regression analysis identified treatment time since onset and age at onset as the factors affecting prevalence, which was 61.8% in the insulin-treated subgroup vs 37% among those treated with oral antihyperglycaemics (p < 0.0001). The prevalence of proliferative diabetic retinopathy was 5.8% in the whole group.

Alcohol Consumption and the Prevalence of Diabetic Retinopathy

To determine if alcohol consumption is associated with the prevalence of diabetic retinopathy. This study surveyed a population-based sample (n = 1210) of younger-onset diabetic persons (diagnosed before age 30 years and taking insulin) and a stratified random sample (n = 1780) of older-onset diabetic persons (diagnosed after age 30 years). Baseline and 4-year follow-up examinations completed by 996 and 891 (730 by persons age 21 or older) younger-onset persons, respectively, and 1370 and 987 older-onset persons, respectively. Data analyzed are from the 4-year follow-up examination. Questionnaires concerning consumption were completed at follow-up. Diabetic retinopathy as determined from stereographic fundus photography. After controlling for known risk factors in the adult younger-onset group, average alcohol consumption, as determined by questionnaire, was inversely associated with prevalence of proliferative diabetic retinopathy (PDR), odds ratio, 0.49; 95% confidence interval, 0.27 to 0.92. The trend was similar for recent consumption, odds ratio, 0.63; confidence interval, 0.37 to 1.09. In the older-onset groups taking or not taking insulin, average or recent alcohol consumption or usage history were not significantly associated with the prevalence of any retinopathy or PDR. Alcohol consumption does not appear to increase the risk of retinopathy and may have a beneficial effect in younger-onset persons, although further study is needed.

High prevalence of proliferative retinopathy in diabetic patients with low pancreatic B-cell capacity

A retrospective study on the role of pancreatic B-cell insulin secretory capacity in the development of proliferative diabetic retinopathy was performed in 160 diabetic patients with a duration of diabetes of more than 10 years (mean 19.5 ± 7.9 years). Pancreatic B-cell insulin secretory capacity was assessed in terms of the quantity of C-peptide excreted into urine per day (24-h urinary C-peptide). When the patients were divided into three groups according to the quantity of 24-h urinary C-peptide (group I, C-peptide < 30 μg, n = 49; group II, 30 μg ≤ C-peptide < 80 μg, n = 76; and group III, C-peptide ≥ 80 μg, n = 35), the prevalence of proliferative diabetic retinopathy was much higher in group I (26.5%) than in group II (5.3%) or group III (2.9%). The incidence of proliferative diabetic retinopathy during the follow-up period (mean 9.8 ± 4.8 years) was also highest in group I (20.0%, 2.7%, and 2.9% in groups I, II, and III, respectively). Other factors which might affect the development of proliferative diabetic retinopathy, including duration of diabetes and past glycemic control, were comparable in these three groups. In contrast, a division of the patients according to glycemic control revealed a strong correlation between glycemic control and background diabetic retinopathy whereas no such correlation was apparent with proliferative diabetic retinopathy. These data are consistent with the view that low pancreatic B-cell. insulin secretory capacity may be a risk factor for the development of proliferative diabetic retinopathy.