Decline in the Cumulative Incidence of Severe Diabetic Retinopathy in Patients With Type 1 Diabetes
- Janne P. Kytö, MD1,2,
- Valma Harjutsalo, PHD2,3,4,
- Carol Forsblom, DMSC2,4,
- Kustaa Hietala, MD1,2,
- Paula A. Summanen, MD, DMSC, FEBO1,
- Per-Henrik Groop, MD, DMSC2,4,5⇓ and
- on behalf of the FinnDiane Study Group
- 1Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland
- 2Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- 3Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- 4Department of Medicine, Division of Nephrology, Helsinki University Central Hospital, Helsinki, Finland
- 5Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Corresponding author: Per-Henrik Groop, .
OBJECTIVE To determine if the cumulative incidence of severe retinopathy in patients with type 1 diabetes has changed.
RESEARCH DESIGN AND METHODS The study looked at 3,781 patients diagnosed with type 1 diabetes (1939–2005), median age at onset 13 (interquartile range [IQR] 9–21) years, and duration of diabetes 19 (IQR 13–27) years. The severe retinopathy was based on a history of laser treatment. Patients were divided into <1975, 1975–1979, 1980–1984, and ≥1985 cohorts according to the diagnosis of diabetes.
RESULTS The cumulative incidence of severe retinopathy has declined (P < 0.0001). After 20 years of duration, the cumulative incidence was 23% (95% CI 21–25) and 33 (30–35) in the earliest cohorts, 18 (15–21) in the next cohort, and 6 (4–9) in the recent cohort. After 30 years, the cumulative incidence was 52 and 48% in the earliest cohorts, while it was 62% after 40 years in the earliest cohort.
CONCLUSIONS The cumulative incidence of severe retinopathy has declined in patients with type 1 diabetes.
This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc10-2391/-/DC1.
See accompanying editorial, p. 2130.
- Received December 20, 2010.
- Accepted March 27, 2011.
- © 2011 by the American Diabetes Association.
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