Incidence and Progression of Diabetic Retinopathy with Special Reference to the Control of Diabetes Mellitus
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Incidence and progression of diabetic retinopathy with special reference to the degree of control of diabetes were investigated in patients attending our diabetes clinic.<BR>All the necessary data concerning history, physical and laboratory examinations were obtained in 624 untreated cases at the begining of the visit. Diabetic retinopathy was found in about 10 per cent of the patients when the duration of diabetes was estimated to be under 1 year.<BR>This incidence, however, became greater as the duration of the disease was prolonged, without regard to the age of the patients, thus exceeding 50 per cent when the duration was more than 10 years. Incidence of retinopathy was lower among patients whose fasting blood sugar before the treatment was under 140mg/dl, irrespective of the duration of the disease.<BR>Remarkable increase in the incidence was observed, however, not only with the prolongation in duration of the disease, but also with the increment in pre-treatment fasting blood sugar level.<BR>Careful follow-up of fundi, examined exclusively by specialists, were performed in 227 patients who had been under constant medical observation including necessary laboratory examinations.<BR>It is to be emphasized that control of diabetes was determined in our study entirely on the basis of fasting blood sugar which was repeatedly determined whenever patients visited our clinic at intervals ranging in almost all the cases between one and 4 weeks. Control of diabetes was judged "good" when 80 per cent or more of the fasting blood sugar remained below 139mg/dl with Hagedorn-Jensen method.<BR>On the other hand, judgement of "poor" control was made when more than 50 per cent of the fasting blood sugar was higher than 170mg/dl. So-called labile type was included in this group. "Fair" control was defined as the intermediate between these categories.<BR>Incidence of patients with appearnce of retinopathy during the period of observation or with progress of diabetic retinopathy based on Wagener's classification were studied.<BR>Significant difference was already noted after the first 2 years. Incidence of progression of diabetic retinopathy became gradually higher when control became worse in the order of good, fair and poor.<BR>It is also to be stressed that the progression of retinopathy was minimized even in patients with higher fasting blood sugar level before treatment, so long as good control was obtained.<BR>This difference in progression of retinopathy became even more marked when the period of observation was increased to 4 and 6 years.<BR>The incidence of progression. was also significantly higher in patients over 50 years of age compared with those under 49 years of age at the time of first visit.<BR>Blood pressure, arteriosclerosis of the retina and levels of serum total lipid were found to have no significant correlation to the progression of retinopathy.<BR>In order to inhibit or to prevent progression of diabetic retinopathy, importance of strict control especially in younger patients with diabetes was emphasized.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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