Cited by 528Retinal Diseases and TreatmentsDiabetes Management and ResearchRetinal Imaging and Analysis

Glycosylated Hemoglobin Predicts the Incidence and Progression of Diabetic Retinopathy

Klein, Ronald·1988·JAMA: The Journal of the American Medical Association

Abstract

The relationship between hyperglycemia, measured by glycosylated hemoglobin at the initial examination, and the four-year incidence and progression of diabetic retinopathy was examined in a population-based study in Wisconsin. Younger- (n = 891) and older-onset (n = 987) persons participating in baseline and follow-up examinations were included. Glycosylated hemoglobin was measured by microcolumn. Retinopathy was determined from stereoscopic fundus photographs. In the younger-onset group, comparing the highest with the lowest quartile of glycosylated hemoglobin, the relative risk for developing any diabetic retinopathy was 1.9; for proliferative retinopathy, 21.8; and for progression, 4.0. Among older-onset persons taking insulin, the corresponding relative risks were 1.9, 4.0, and 2.1. Among older-onset persons not taking insulin, relative risks were 4.0 for any retinopathy and 6.2 for progression. A positive relationship between incidence and progression of retinopathy and glycosylated hemoglobin remained after controlling for duration of diabetes, age, sex, and baseline retinopathy. These data suggest a strong and consistent relationship between hyperglycemia and incidence and progression of retinopathy. (JAMA1988;260:2864-2871)

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Crossref · 10.1001/jama.1988.03410190112033

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Authors
Klein, R.
Affiliations
University of Wisconsin–Madison (US)
Corresponding author
Klein, Ronald
Venue
JAMA: The Journal of the American Medical Association
Published
1988-11-18
Volume
260
Issue
19
Pages
2864
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
OpenAlex
W2034900477
Cited by
528
References
0
Citations by year
2026: 2 · 2025: 6 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 8 · 2020: 7 · 2019: 7 · 2018: 8 · 2017: 7 · 2016: 6 · 2015: 12 · 2014: 13 · 2013: 7 · 2012: 19
FWCI
19.76
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (P30-AM AG-26659)
  • National Eye Institute (EY0-3083)
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
Keywords
HbA1c, diabetic retinopathy, hyperglycemia, retinopathy incidence, retinopathy progression, proliferative diabetic retinopathy, insulin therapy, diabetes duration
MeSH terms
Adult, Age Factors, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Hyperglycemia, Male, Physical Examination, Prognosis, Models, Statistical, Cohort Studies

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