Acta Diabetologica

, Volume 51, Issue 3, pp 413–420 | Cite as

The 16-year incidence, progression and regression of diabetic retinopathy in a young population-based Danish cohort with type 1 diabetes mellitus: The Danish cohort of pediatric diabetes 1987 (DCPD1987)

  • Rebecca Broe
  • Malin Lundberg Rasmussen
  • Ulrik Frydkjaer-Olsen
  • Birthe Susanne Olsen
  • Henrik Bindesboel Mortensen
  • Tunde Peto
  • Jakob Grauslund
Original Article

Abstract

The aim was to investigate the long-term incidence of proliferative diabetic retinopathy (PDR), and progression and regression of diabetic retinopathy (DR) and associated risk factors in young Danish patients with Type 1 diabetes mellitus. In 1987–89, a pediatric cohort involving approximately 75 % of all children with Type 1 diabetes in Denmark <19 years of age was identified (n = 720). In 1995, 339 (47.1 %) were re-studied with retinopathy graded and all relevant diabetic parameters assessed. Of those, 185 (54.6 %) were evaluated again in 2011 for the same clinical parameters. All retinal images were graded using modified early treatment of DR study for 1995 and 2011. In 1995, mean age was 21.0 years and mean diabetes duration 13.5 years. The 16-year incidence of proliferative retinopathy, 2-step progression and 2-step regression of DR was 31.0, 64.4 and 0.0 %, respectively, while the incidence of DR was 95.1 %. In a multivariate logistic regression model, progression to PDR was significantly associated with 1995 HbA1c (OR 2.61 per 1 % increase, 95 % CI 1.85–3.68) and 1995 diastolic blood pressure (OR 1.79 per 10 mmHg increase, 95 % CI 1.04–3.07). Two-step progression of DR was associated with male gender (OR 2.37 vs. female, 95 % CI 1.07–5.27), 1995 HbA1c (OR 3.02 per 1 % increase, 95 % CI 2.04–4.48) and 1995 vibration perception threshold (OR 1.19 per 1 Volt increase, 95 % CI 1.02–1.40). In conclusion, one in three progressed to PDR and two in three had 2-step progression despite young age and increased awareness of the importance of metabolic control. After 30 years duration of diabetes, the presence of DR is almost universal.

Keywords

Non-proliferative diabetic retinopathy Proliferative diabetic retinopathy Risk factors Incidence Type 1 diabetes mellitus Population-based 

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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • Rebecca Broe
    • 1
    • 2
    • 3
  • Malin Lundberg Rasmussen
    • 1
    • 2
  • Ulrik Frydkjaer-Olsen
    • 1
    • 2
  • Birthe Susanne Olsen
    • 4
    • 5
  • Henrik Bindesboel Mortensen
    • 4
    • 5
  • Tunde Peto
    • 2
    • 6
  • Jakob Grauslund
    • 1
    • 2
  1. 1.Department of OphthalmologyOdense University HospitalOdense CDenmark
  2. 2.The Clinical Research InstituteUniversity of Southern DenmarkOdenseDenmark
  3. 3.OPEN Odense Patient Data Explorative NetworkOdense University HospitalOdenseDenmark
  4. 4.Department of Pediatrics EHerlev HospitalHerlevDenmark
  5. 5.Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
  6. 6.The NIHR Biomedical Research CentreMoorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK

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