You
are correct...
Which of the following is the most prevalent micro/macrovascular
complication with Diabetes?
1. Retinopathy
2. Neuropathy
3. Nephropathy
4. Cardiovacular disease
Diabetic retinopathy affects all retinal cell types.
The bars show the proliferative retinopathy. And by 30 years of diabetes
about half of the type 1 diabetic patients studied in Wisconsin some
years ago had proliferative change. Macular edema is peaking at about
15%. Retinopathy is common. Serious retinopathy is also common.
The retinopathy plateau here is less, 65%. In the previous example
when you saw that the prevalence of serious retinopathy declined with
increasing duration, that's not because it's getting better. Unfortunately
the people with the complication die. The others are the survivors.
But in type 2 diabetes we have a rapid attrition, a high mortality,
and the prevalence would actually continue to rise if we were plotting
it as a cumulative figure.
At year 0, about 25% (28%) already have retinopathy at the time of diagnosis
of type 2 diabetes. In the United Kingdom Prospective Diabetes Study
(UKPDS), 37% were found to have retinopathy at the time of diagnosis.
The difference probably relates to exactly how the retinopathy was being
assessed. So here we have a condition that presents with what we've
traditionally regarded as a long-term complication.
In terms of serious retinopathy in type 2 diabetes, about 15%, the
same as type 1 diabetes, eventually have macular edema. And about 15%
also develop proliferative retinopathy after 25 years of diabetes.
Data from the DCCT and the UKPDS have shown that Retinopathy is the
most prevalent complication from diabetes and is usually present 50%
of the time at diagnosis. DCCT/UKPDS
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