Session Title: Free Paper Session 19: Vascular Diseases & Diabetic Retinopathy V
Session Date/Time: Saturday 09/09/2017 | 16:30-18:00
Paper Time: 16:48
Venue: Room 120
First Author: : K.Hatz SWITZERLAND
Co Author(s): : A. Minder R. Lehmann B. Gerendas U. Schmidt Erfurth C. Pruente H. Zulewski
We evaluated the diabetic retinopathy (DR) prevalence and its correlation with the HbA1c load (HbA1c years) as well as conventional parameters in type 1 diabetes mellitus (T1DM) adults treated with intensified insulin therapy (IIT) from the onset of disease.
Cross sectional analysis of 151 adults with T1DM (5-29 years duration) treated at two university-based diabetic centres (Basel/Zurich).
Imaging according to standard study procedures included: ETDRS 7-field colour stereoscopic photography (CF) and fluorescein angiography (FA), SD-OCT (optical coherence tomography). Grading of images was carried out by the Vienna Reading centre. DR was graded from 0 to 4 (0=no DR, 1=mild non-proliferative DR (NPDR), 2= moderate NPDR, 3=severe NPDR, 4= proliferative DR (PDR)). The maximum DR status (worse eye) as well as the mean of DR status of both eyes of each patient were used to perform uni- and multivariate analyses (Pearson) regarding the influence of blood glucose control (actual HbA1c, individual longterm mean HbA1c), duration of T1DM and the total HbA1c load over the whole duration of disease (HbA1c years).
The mean duration of T1DM was 14.3±5.8 years, mean current HbA1c 7.6±1.2% (Median 7.4%), mean of individual mean HbA1c 7.5±1.1% (Median 7.3%), mean HbA1c years 22±18. 39% of patients had no signs of DR in both eyes, in 28% the maximum DR stage was 1, in 27% 2, in 5% 3 and one patient showed in one eye PDR. A significant correlation with maximum DR status (worse eye) as well as mean DR status of both eyes was shown for current HbA1c (p=0.0240; p=0.0025), individual mean HbA1c (p=0.0024; p<0.0001), duration of T1DM (p<0.0001). HbA1c years highly correlated with the DR status (p<0.0001). All influences remained significant after adjusting for age, sex and T1DM duration (multivariate analyses).
The prevalence of DR in patients with T1DM treated with IIT from onset of the disease is low and highly correlated with the new parameter HbA1c years.