Incidence of complications in insulin-dependent diabetes mellitus: a survival analysis

American Journal of Epidemiology
C E LloydT J Orchard

Abstract

The authors used 4-year incidence data from the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study to investigate the wider applicability of recent research findings that demonstrate an association between glycemic control and insulin-dependent diabetes mellitus (IDDM) complications. EDC subjects participated in clinical examination at baseline (1986-1988) and were followed up every 2 years. Results demonstrated that, during the first 4 years of follow-up, subjects who were in "poor" control (glycosylated hemoglobin (GHb) > or = 11%) at baseline were significantly (p < 0.001) more likely to develop microalbuminuria, proliferative retinopathy, and distal symmetrical polyneuropathy (DSP), compared with subjects who were in "fair" control (GHb < 11%). Subjects who were in poor control were somewhat more likely to develop overt nephropathy (p = 0.08) and renal failure (p = 0.085) during follow-up; however, no associations were observed with either coronary heart disease or lower extremity arterial disease (LEAD). These results confirm the strong association between prior glycemic control and the onset of microalbuminuria, proliferative retinopathy, and DSP observed in the Diabetes Control and Complications Trial study. H...Continue Reading

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