Relationship between the Mode of Diabetes and Early Retinopathy in Juvenile Onset Insulin-Dependent Diabetes Mellitus.

概要

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Early retinal changes evaluated by ophthalmoscopy and fluorescein angiography (FAG) were studied in two groups of juvenile onset insulin-dependent diabetes mellitus (IDDM) patients. Twenty one patients representing abrupt onset with clinical symptoms at diagnosis (Group A) and 19 patients with slow onset detected by chance during urine glucose screening at school (Group B) were examined. The aim of the study was to investigate the relationship between the prevalence of incipient retinopathy during 10 years of diabetes and the mode of onset of IDDM.<BR>There was no statistical differences in age at diagnosis and annual average HbA<SUB></SUB>1 values between the two groups. Group B patients maintained higher serum C-peptide (S-CPR) levels than Group A patients during the study. Despite higher S-CPR values, the progression of retinal abnormalities detected by both ophthalmoscopy and FAG was more rapid in Group B than Group A. Long-term glycemic control, since the rapid onset of diabetes seemed to affect the development of retinal abnormalities seen in Group A, which were not seen in Group B. There was no statistical difference in HLA phenotypes between the patients with and without retinal abnormalities. From these findings, it is concluded that the mode of onset of diabetes as well as the duration and the metabolic control may affect the development of early retinopathy in juvenile onset IDDM.
一般社団法人日本糖尿病学会の論文