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Item #11
Risk
of Retinopathy Is Lower in Type 2 With Onset in Youth
"The
epidemic of type 2 diabetes in youth is likely to lead to an epidemic
of microvascular disease while these patients are still young
adults."
In
a recent study it was shown
that, the risk of retinopathy in relation to disease duration is lower
in those who developed diabetes at a young age than in those with
onset in adulthood.. JohnstonSue@uams.edu
Dr.
Jonathan Krakoff and colleagues from the National Institutes of
Health, Phoenix, Arizona, followed patients diagnosed with diabetes
for microvascular complications in a longitudinal study of health in
the Pima Indians of Arizona. They compared the risk of retinopathy and
nephropathy in patients with youth-onset type 2 diabetes (before 20
years of age) with that in patients with adult-onset diabetes.
"Diabetes
was diagnosed in 178 subjects before 20 years of age (youth), in 1359
subjects at 20 to 39 years of age (younger adults) and in 971 subjects
at 40 to 59 years of age (older adults)," the authors note. They
calculated incidence rates of retinopathy and nephropathy by age at
diagnosis.
Thirty-five
patients with youth-onset diabetes developed nephropathy over 25
years. This incidence rate was similar to that of patients with
adult-onset diabetes (p = 0.77). However, those with youth-onset
diabetes had significantly lower incidence rates of retinopathy (p =
0.007).
Specifically,
compared with subjects in the adult-onset group, those in the
youth-onset group had a lower risk of retinopathy after adjusting for
fasting glucose level, sex, mean arterial pressure, and duration to
first examination after diabetes diagnosis (hazard rate ratio [HRR]
0.42, p = 0.003). The risk of nephropathy was similar between the
groups (HRR 1.2, p = 0.38).
Dr.
Krakoff and colleagues point out that, although the risk of
retinopathy in youth is relatively low, nonetheless a
"substantial" proportion of such patients do develop
retinopathy at a young age. Given that, along with the undiminished
risk of nephropathy, they conclude that "the epidemic of type 2
diabetes in youth is likely to lead to an epidemic of microvascular
disease while these patients are still young adults."
Diabetes
Care 2003;26:76-81.
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DO
YOU KNOW the new definition for the
metabolic syndrome (syndrome X)?
Three
or more of the following:
-
Waist
circumference greater than 40 inches (102 cm) in men, greater than
35 inches (88 cm) in women
-
A
serum triglyceride level above 150 mg/dL (1.7 mmol/L)
-
'Good'
cholesterol (HDL) below 40 mg/dL (1.04 mmol/L) in men, below 50
mg/dL (1.29 mmol/L) in women
-
Blood
pressure raised; above 135/85 mm Hg
-
Fasting
blood glucose above 110 mg/dL (6.1 mmol/L)
-
Check
out the Open Fiber Study (Click
Here)
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