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Original Articles

Contribution of Diabetes Duration Before Puberty to Development of Microvascular Complications in IDDM Subjects

  1. Jill Norris Kostraba, MPH,
  2. Janice S Dorman, PhD,
  3. Trevor J Orchard, MBBCh,
  4. Dorothy J Becker, MBBCh,
  5. Yukashi Ohki, MD,
  6. Demetrius Ellis, MD,
  7. Bernard H Doft, MD,
  8. Louis A Lobes, MD,
  9. Ronald E LaPorte, PhD and
  10. Allan L Drash, MD
  1. Department of Epidemiology, Graduate School of Public Health and Department of Ophthalmology, University of Pittsburgh School of Medicine; the Division of Endocrinology and Metabolism, Department of Pediatrics, and Division of Nephrology, Children's Hospital of Pittsburgh; and the Ear and Eye Hospital Pittsburgh, Pennsylvania
  1. Address correspondence and reprint requests to Jill Norris Kostraba, MPH, Diabetes Research Center of Children's Hospital of Pittsburgh, 3600 Forbes Avenue, Suite 502, Pittsburgh, PA 15213.
Diabetes Care 1989 Nov; 12(10): 686-693. https://doi.org/10.2337/diacare.12.10.686
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Abstract

The contribution of diabetes duration, both pre- and postpuberty, to the development of microvascular complications and mortality in diabetic subjects was investigated in three study populations from the Children's Hospital of Pittsburgh Insulin-Dependent Diabetes Mellitus (IDDM) Registry. Life-table analyses by total and postpubertal IDDM duration were used to evaluate differences in the prevalence of microvascular complications and diabetes-related mortality in subjects diagnosed before and during puberty, as defined by an age at IDDM onset marker of 11 yr for girls and 12 yr for boys. The prevalence of retinopathy and overt nephropathy in 552 White adult diabetic subjects (population 1, mean IDDM duration 20.8 yr) was significantly greater in subjects diagnosed during puberty compared with those diagnosed before puberty. However, similar analyses by postpubertal duration showed no difference in microvascular complication prevalence between the two groups. These findings did not appear to be due to a confounding effect of age. Additional analyses of 239 adolescent diabetic subjects (population 2, mean duration 8.3 yr) revealed the same trend for the prevalence of retinopathy. Finally, results concerning the risk of diabetes-related mortality in a cohort of 1582 subjects (population 3, mean duration 12.9 yr) indicated that postpubertal duration of IDDM may be a more accurate determinant of the development of microvascular complications and diabetes-related mortality than total duration, and it is suggested that the contribution of the prepubertal years of diabetes to long-term prognosis may be minimal.

  • Copyright © 1989 by the American Diabetes Association

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November 1989, 12(10)
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Contribution of Diabetes Duration Before Puberty to Development of Microvascular Complications in IDDM Subjects
Jill Norris Kostraba, Janice S Dorman, Trevor J Orchard, Dorothy J Becker, Yukashi Ohki, Demetrius Ellis, Bernard H Doft, Louis A Lobes, Ronald E LaPorte, Allan L Drash
Diabetes Care Nov 1989, 12 (10) 686-693; DOI: 10.2337/diacare.12.10.686

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Contribution of Diabetes Duration Before Puberty to Development of Microvascular Complications in IDDM Subjects
Jill Norris Kostraba, Janice S Dorman, Trevor J Orchard, Dorothy J Becker, Yukashi Ohki, Demetrius Ellis, Bernard H Doft, Louis A Lobes, Ronald E LaPorte, Allan L Drash
Diabetes Care Nov 1989, 12 (10) 686-693; DOI: 10.2337/diacare.12.10.686
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