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Original Articles

Prevalence of Complications in IDDM by Sex and Duration: Pittsburgh Epidemiology of Diabetes Complications Study II

  1. Trevor J Orchard,
  2. Janice S Dorman,
  3. Raelene E Maser,
  4. Dorothy J Becker,
  5. Allan L Drash,
  6. Demetrius Ellis,
  7. Ronald E LaPorte and
  8. Lewis H Kuller
  1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, and the Division of Endocrinology and Metabolism and Division of Nephrology, Department of Pediatrics, Children's Hospital of Pittsburgh Pittsburgh, Pennsylvania
  1. Address correspondence and reprint requests to Trevor J. Orchard, MD, Diabetes Research Center, Suite 502A, 3600 Forbes Avenue, Pittsburgh, PA 15213.
Diabetes 1990 Sep; 39(9): 1116-1124. https://doi.org/10.2337/diab.39.9.1116
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Abstract

The prevalence of and interrelationships among all four major complications of insulin-dependent diabetes mellitus (IDDM) and their risk factors are being examined in a large epidemiologic study of IDDM subjects diagnosed in childhood. This article focuses on the baseline prevalence of complications in the 657 subjects diagnosed between 1950 and 1980 and currently aged 8–48 yr, with a mean duration of 20 yr. In addition to background retinopathy being virtually universal after 20 yr of diabetes, proliferative retinopathy affects 70% of IDDM subjects after 30 yr duration. As with overt nephropathy, prevalence of proliferative retinopathy is marginally higher in females than in males at short durations; the previously reported male excess is limited to the subjects with IDDM of longer duration (≥25 yr). Somewhat different patterns of microalbuminuria are also seen by sex. Males show a threefold increase in prevalence from 10 to 25 yr duration, whereas females show a more constant prevalence across these durations. A further rise in microalbuminuria is seen in males but not females at ≥30 yr duration, giving a combined prevalence of microalbuminuria and overt nephropathy at ≥30 yr duration of 84% (males) and 59% (females). Distal symmetrical polyneuropathy shows a constant rise with duration and is only marginally higher in men. Prevalence of cardiovascular (coronary and cerebral) disease shows no sex difference, whereas peripheral vascular disease is particularly common in women after 30 yr duration (>30%) compared with men (11%) when determined by ankle/arm blood pressure ratio <0.8 at rest or after exercise. These results suggest that the natural history of IDDM complications varies considerably by sex and that the prevalence of complications (especially renal complications in males) may be higher than previously recognized.

  • Received September 29, 1989.
  • Revision received April 27, 1990.
  • Accepted April 27, 1990.
  • Copyright © 1990 by the American Diabetes Association

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September 1990, 39(9)
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Prevalence of Complications in IDDM by Sex and Duration: Pittsburgh Epidemiology of Diabetes Complications Study II
Trevor J Orchard, Janice S Dorman, Raelene E Maser, Dorothy J Becker, Allan L Drash, Demetrius Ellis, Ronald E LaPorte, Lewis H Kuller
Diabetes Sep 1990, 39 (9) 1116-1124; DOI: 10.2337/diab.39.9.1116

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Prevalence of Complications in IDDM by Sex and Duration: Pittsburgh Epidemiology of Diabetes Complications Study II
Trevor J Orchard, Janice S Dorman, Raelene E Maser, Dorothy J Becker, Allan L Drash, Demetrius Ellis, Ronald E LaPorte, Lewis H Kuller
Diabetes Sep 1990, 39 (9) 1116-1124; DOI: 10.2337/diab.39.9.1116
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© 2021 by the American Diabetes Association. Diabetes Print ISSN: 0012-1797, Online ISSN: 1939-327X.