Diabetes Care, Vol 16, Issue 8 1184-1186, Copyright © 1993 by American Diabetes Association
Risk factors for development of retinopathy in elderly Japanese patients with diabetes mellitus
A Araki, H Ito, A Hattori, J Inoue, T Sato, M Shiraki and H Orimo
Endocrinology and Metabolism Section, Tokyo Metropolitan Geriatric Hospital, Japan.
OBJECTIVE--To define the risk factors for the development of diabetic
retinopathy in elderly patients with diabetes mellitus. RESEARCH DESIGN AND
METHODS--We studied 110 diabetic outpatients > 60 yr of age who were
free of diabetic retinopathy at the first visit and were followed for at
least 5 yr to examine the relationships between the initial findings and
the subsequent development of retinopathy. RESULTS--A total of 49 of the
subjects developed diabetic retinopathy during the follow-up period; of
these, 4 patients progressed to preproliferative and 3 to proliferative
retinopathy. Univariate analysis showed that the initial fasting plasma
glucose levels, the HbA1 values, the 2-h postload plasma glucose levels,
the estimated duration of diabetes, and the presence of persistent
proteinuria were all associated with the development of diabetic
retinopathy. However, age at the initial examination, estimated age at
diabetes onset, sex, body mass index, type of therapy, and hypertension had
little impact on the development of retinopathy. Stepwise multiple Cox
regression analysis revealed that the initial HbA1 or fasting plasma
glucose, the diabetes duration, and the presence of persistent proteinuria
are significant independent predictors for the development of retinopathy.
CONCLUSIONS--Initial fasting plasma glucose, diabetes duration, and
proteinuria are important risk factors for the development of retinopathy
in elderly patients with diabetes mellitus.