Glucose Control and the Renal and Retinal Complications of Insulin-dependent Diabetes
Abstract
Two hundred thirty subjects with insulin-dependent diabetes were followed up longitudinally by measuring glycohemoglobin values to relate glucose control with renal and retinal complications. Subjects with long-term poor control (glycohemoglobin values >1.5 times the upper limit of normal) had 3.6 times the prevalence of microalbuminuria and 2.5 times the prevalence of level 3 to 6 retinopathy than that found in subjects with long-term good control (glycohemoglobin values within 1.33 times the upper limit of normal). Variables related to kidney damage were glucose control and, to a lesser degree, duration of diabetes. Variables related to eye disease were, in descending order of significance, duration of diabetes, glucose control, and age. No subject whose mean glycohemoglobin value was consistently within 1.1 times the upper limit of normal had retinopathy or microalbuminuria. In contrast, when the mean glycohemoglobin value was more than 1.5 times the upper limit of normal, 24 (29%) of 82 subjects had microalbuminuria and 30 (37%) of 82 had level 3 to 6 retinopathy. (JAMA1989;261:1155-1160)
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Clinical trials, in concert with epidemiological data, support decreasing glycemia as an effective means of reducing long-term microvascular and neuropathic complications.
“The clinical trials, in concert with epidemiological data (18,19), support decreasing glycemia as an effective means of reducing long-term microvascular and neuropathic complications.”
From Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy (2009) · cites this paper as [19]
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- Authors
- Chase, H. P.
- Corresponding author
- Chase, H. Peter
- Venue
- JAMA: The Journal of the American Medical Association
- Publisher
- American Medical Association (AMA)
- Published
- 1989-02-24
- Volume
- 261
- Issue
- 8
- Pages
- 1155
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2118505517
- Cited by
- 254
- References
- 0
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 2 · 2017: 3 · 2016: 2 · 2015: 4 · 2014: 3 · 2013: 3 · 2012: 6
- FWCI
- 12.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Keywords
- type 1 diabetes, glycemic control, glycohemoglobin, microalbuminuria, diabetic nephropathy, diabetic retinopathy, diabetic eye disease, diabetes duration, kidney injury, retinopathy severity
- MeSH terms
- Adolescent, Adult, Age Factors, Albuminuria, Blood Glucose, Diabetes Mellitus, Type 1, Diabetic Nephropathies, Diabetic Retinopathy, Female, Glycated Hemoglobin, Humans, Longitudinal Studies, Male, Risk Factors, Time Factors
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