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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

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العنوان:	Impact of Age of Onset, Puberty, and Glycemic Control Followed From Diagnosis on Incidence of Retinopathy in Type 1 Diabetes: The VISS Study
المؤلفون:	Johnny Ludvigsson, Mats Fredriksson, Hans J. Arnqvist, Maria Nordwall
المصدر:	Diabetes Care. 42:609-616
بيانات النشر:	American Diabetes Association, 2019.
سنة النشر:	2019
مصطلحات موضوعية:	Adult, Blood Glucose, Male, Pediatrics, medicine.medical_specialty, Time Factors, Adolescent, Endocrinology, Diabetes and Metabolism, Population, 030209 endocrinology & metabolism, Diagnostic Techniques, Ophthalmological, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Diabetes mellitus, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Sexual Maturation, 030212 general & internal medicine, Young adult, education, Glycated Hemoglobin, Sweden, Advanced and Specialized Nursing, education.field_of_study, Type 1 diabetes, Diabetic Retinopathy, medicine.diagnostic_test, business.industry, Incidence, Incidence (epidemiology), Vitreoretinopathy, Proliferative, Fundus photography, medicine.disease, Diabetes Mellitus, Type 1, Female, Age of onset, business, Retinopathy
الوصف:	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.
تدمد:	1935-5548 0149-5992
الوصول الحر:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c8c0771da7ba37faa24b026519fa57b3Test https://doi.org/10.2337/dc18-1950Test
حقوق:	OPEN
رقم الانضمام:	edsair.doi.dedup.....c8c0771da7ba37faa24b026519fa57b3
قاعدة البيانات:	OpenAIRE

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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. 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