Rate of beta-cell destruction in type 1 diabetes influences the development of diabetic retinopathy: protective effect of residual beta-cell function for more than 10 years.
J Clin Endocrinol Metab
; 93(12): 4759-66, 2008 Dec.
Article
en En
| MEDLINE
| ID: mdl-18826998
ABSTRACT
CONTEXT Although residual beta-cell function delays the onset and progression of diabetic retinopathy in patients with type 1 diabetes, the rate of beta-cell destruction is variable. OBJECTIVE:
The aim of the study was to clarify the influence of the rate of beta-cell destruction on the development and progression of diabetic retinopathy in type 1 diabetes.DESIGN:
We performed a historical cohort study regarding residual beta-cell function and retinopathy.SETTING:
The study was conducted in the outpatient clinic of a general hospital. PATIENTS A total of 254 patients with type 1 diabetes participated. MAIN OUTCOMEMEASURES:
Serum C-peptide and fundus findings were evaluated longitudinally.RESULTS:
The cumulative incidence of mild nonproliferative diabetic retinopathy was higher in the patients without detectable beta-cell function than in those with residual beta-cell function at 20, 15, and 10 yr after the onset of diabetes (P = 0.013, P = 0.006, and P = 0.048, respectively), but not at 5 yr after the onset (P = 0.84). There were higher mean glycosylated hemoglobin values during the entire follow-up period in the patients without detectable beta-cell function at 20 and 15 yr after the onset of diabetes (P = 0.030 and P = 0.042, respectively). Positivity for HLA-A24 and -DQA1 03, as well as the acute onset of diabetes, was associated with early beta-cell loss and also with early development of diabetic retinopathy. Cox proportional hazards analysis showed that undetectable beta-cell function at 20, 15, or 10 yr after the onset of diabetes was an independent risk factor for the development of diabetic retinopathy.CONCLUSIONS:
Undetectable beta-cell function within 10 yr of the onset of type 1 diabetes is associated with the earlier occurrence of diabetic retinopathy.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Diabetes Mellitus Tipo 1
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Retinopatía Diabética
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Células Secretoras de Insulina
Tipo de estudio:
Etiology_studies
/
Incidence_studies
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Observational_studies
/
Risk_factors_studies
Límite:
Adult
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Female
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Humans
/
Male
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2008
Tipo del documento:
Article
País de afiliación:
Japón