Effect of Diabetic Control on the Development of Retinopathy in Non-Insulin-Dependent Diabetes Mellitus. Prospective Follow-up Study for 8 years.

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  • ＮＩＤＤＭにおける網膜症発症予防のための血糖コントロールの検討　８年間のｆｏｌｌｏｗ‐ｕｐ　ｓｔｕｄｙ
  • Prospective Follow-up Study for 8 years
  • 8年間のfollow-up study

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Abstract

To determine the optimum (HbA1c) value for preventing retinopathy, the progression of retinopathy and HbA1c values in patients with non-insulin-dependent diabetes mellitus (NIDDM) were followed for 8 years. We examined 176 patients first diagnosed with NIDDM, aged 30-65 years, diabetic duration less than 3 years and without retinopathy. The appearance and progression of retinopathy were assessed at least annually. The mean HbA1c value for each patient was calculated by using data of every month except the data at registration. Multiple logistic regression analysis for the mean HbA1c value, onset age, sex, blood pressure, and ΔBMI (Max BMI-BMI at registration) with retinopathy at the end point as dependent variables, showed a significant impact of the mean HbA1c value and ΔBMI. In the group with HbA1c values below 6%, no patients had retinopathy. Patients with HbA1c values above 8% had a prevalence rate 4 times higher than patients with HbA1c values below 8%. The prevalence of retinopathy increased with the increase in the mean HbA1c values over 8 years (trend P<0.05). The data suggest that an HbA1c value below 6% should be effective in preventing diabetic retinopathy in patients with NIDDM.

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