2001 OCT 1 - (NewsRx.com & NewsRx.net) --
by Sonia Nichols, senior medical writer - Age, body mass index (BMI), and glucose control are just some of the risk factors for diabetic retinopathy progression and proliferation in types 1 and 2 diabetes patients, according to World Health Organization (WHO) collaborators.
Diabetic retinopathy, characterized by hemorrhage, microaneurysms, lesion formation, and sometimes new blood vessel overgrowth (proliferative retinopathy) in the retina, can lead to total vision loss in diabetes patients. A follow-up study of almost 3,000 patients with types 1 or 2 diabetes at 10 WHO centers suggests several factors contribute to progressive eye disease in patients with diabetic retinopathy.
Originally, investigators enrolled over 4,600 patients with diabetes in the study. More than 500 of those patients were lost to follow-up due to death, according to H. Keen and colleagues, Guy's Hospital, London, U.K. During follow-up 47.7% of patients who did not have retinopathy at study enrollment developed retinopathy, and 9.7% developed proliferative retinopathy, according to Keen and colleagues.
'Incident retinopathy appeared earlier in the known course of diabetes but incidence rates rose more slowly with duration in patients with type 2 (non-insulin-dependent) diabetes mellitus than in those with type 1 (insulin-dependent) diabetes mellitus,' reported Keen and coworkers.
After pooling the data from the several study centers, researchers identified several factors that increased the odds of incident retinopathy, which they listed as 'age, diabetes duration, systolic pressure, plasma cholesterol, BMI, insulin treatment and proteinuria, and fasting glycemia.'
For those with proliferative diabetic retinopathy, 'age, diabetes duration, insulin treatment, cholesterol, proteinuria, and fasting glycemia' were high-risk factors ('The appearance of retinopathy and progression to proliferative retinopathy: The WHO multinational study of vascular disease in diabetes,' Diabetologia, 2001;44(14):S22-S30).
Although the prevalence of incident retinopathy and proliferative retinopathy varied from center to center, implying observer differences, baseline risk factors for retinopathy remained important throughout the entire study group.
'Improved detection and control of these risk factors should reduce the impact of diabetic retinopathy and its consequences,' Keen and coauthors. said.
The corresponding author for this study is H. Keen, Guy's Hospital, London, UK.
A search at www.NewsRx.net using the search term 'diabetic retinopathy' yielded over 47 articles in 11 specialized reports.
Key points reported in this study include:
* A major WHO study identified incident retinopathy in almost 50% of type 1 and 2 diabetic patients followed for an average of 8.4 years
* Proliferative retinopathy was identified in almost 10% of diabetes patients
* Several controllable factors increase the risk for diabetic retinopathy in patients with types 1 and 2 diabetes
This article was prepared by Diabetes Week editors from staff and other reports. Copyright 2001, Diabetes Week via NewsRx.com & NewsRx.net.
