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Impact of Age of Onset, Puberty, and Glycemic Control Followed From Diagnosis on Incidence of Retinopathy in Type 1 Diabetes: The VISS Study
Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Norrköping. Vrinnevi Hosp, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences, Forum Östergötland.
Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
2019 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 42, no 4, p. 609-616Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE To evaluate sex, age at diabetes onset, puberty, and HbA1c, with subjects followed from diabetes diagnosis and during different time periods, as risk factors for developing diabetic simplex and proliferative retinopathy.

RESEARCH DESIGN AND METHODS In a population-based observational study, HbA1c for 451 patients diagnosed with diabetes before 35 years of age during 1983–1987 in southeast Sweden was followed for up to 18–24 years from diagnosis. Long-term mean weighted HbA1c(wHbA1c) was calculated. Retinopathy was evaluated by fundus photography and analyzed in relation to wHbA1c levels.

RESULTS Lower wHbA1c, diabetes onset ≤5 years of age, and diabetes onset before puberty, but not sex, were associated with longer time to appearance of simplex retinopathy. Proliferative retinopathy was associated only with wHbA1c. The time to first appearance of any retinopathy decreased with increasing wHbA1c. Lower wHbA1c after ≤5 years’ diabetes duration was associated with later onset of simplex retinopathy but not proliferative retinopathy. With time, most patients developed simplex retinopathy, except for those of the category wHbA1c≤50 mmol/mol (6.7%), for which 20 of 36 patients were without any retinopathy at the end of the follow-up in contrast to none of 49 with wHbA1c >80 mmol/mol (9.5%).

CONCLUSIONS Onset at ≤5 years of age and lower wHbA1c the first 5 years after diagnosis are associated with longer duration before development of simplex retinopathy. There is a strong positive association between long-term mean HbA1c measured from diagnosis and up to 20 years and appearance of both simplex and proliferative retinopathy.

Place, publisher, year, edition, pages
Arlington, VA, United States: American Diabetes Association , 2019. Vol. 42, no 4, p. 609-616
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-155907DOI: 10.2337/dc18-1950ISI: 000461816500027PubMedID: 30705061Scopus ID: 2-s2.0-85063626496OAI: oai:DiVA.org:liu-155907DiVA, id: diva2:1304470
Note

Funding Agencies|Barndiabetesfonden (the Swedish Child Diabetes Foundation); Forskningsradet i Sydostra Sverige (FORSS) (the Research Council of Southeast Sweden)

Available from: 2019-04-12 Created: 2019-04-12 Last updated: 2019-04-17Bibliographically approved

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Fredrikson, Mats

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Nordwall, MariaFredrikson, MatsLudvigsson, JohnnyArnqvist, Hans
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Center for Social and Affective NeuroscienceFaculty of Medicine and Health SciencesDepartment of Paediatrics in NorrköpingDivision of Neuro and Inflammation ScienceForum ÖstergötlandDivision of Children's and Women's healthH.K.H. Kronprinsessan Victorias barn- och ungdomssjukhusDivision of Cell BiologyDepartment of Endocrinology
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