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Diabetes, Vol 38, Issue 4 460-464, Copyright © 1989 by American Diabetes Association
Risk factors for progression of background retinopathy in long-standing IDDM
HU Janka, JH Warram, LI Rand and AS Krolewski
Research Division, Joslin Diabetes Center, Boston, MA 02215.
Risk factors for the development of severe forms of diabetic retinopathy
were examined prospectively in a group of 153 patients with long-standing
insulin-dependent diabetes mellitus. During a 4-yr follow-up study, 34
individuals progressed to preproliferative and proliferative retinopathy.
The risk of progression to severe forms of diabetic retinopathy was
determined by the degree of background diabetic retinopathy and several
systemic factors. It increased steeply with hemoglobin A1c, declined
proportionally with increasing age, and was dramatically different in
patients with diastolic blood pressure below versus above 70 mmHg. Although
the mechanisms of action of these systemic factors are unclear, the
findings emphasize the multifactorial nature of the pathogenesis of severe
forms of eye lesions.

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Copyright © 1989 by the American Diabetes Association.
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