UKPDS 50: Risk factors for incidence and progression of retinopathy in type II diabetes over 6 years from diagnosis
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Aims/hypothesis To determine risk factors related to the incidence and progression of diabetic retinopathy over 6 years from diagnosis of Type II (non-insulin-dependent) diabetes mellitus.Methods This report describes 1919 patients from within the United Kingdom Prospective Diabetes Study (UKPDS), with retinal photographs taken at diagnosis and 6 years later and with complete data available. Photographs were centrally graded for lesions of diabetic retinopathy using the modified Early Treatment of Diabetic Retinopathy Study Final scale. Risk factors were assessed after 3 months diet from the time of diagnosis of diabetes. Patients were seen every 3 months in a hospital setting. Biochemical measurements were done by a central laboratory. End points of vitreous haemorrhage and photocagulation were confirmed by independent adjudication of systematically collected clinical data. The main outcome measures were incidence and progression of retinopathy defined as a two-step Early Treatment of Diabetic Retinopathy Study (ETDRS) final scale change.Results Of the 1919 patients, 1216 (63 %) had no retinopathy at diagnosis. By 6 years, 22 % of these had developed retinopathy, that is microaneurysms in both eyes or worse. In the 703 (37 %) patients with retinopathy at diagnosis, 29 % progressed by two scale steps or more. Development of retinopathy (incidence) was strongly associated with baseline glycaemia, glycaemic exposure over 6 years, higher blood pressure and with not smoking. In those who already had retinopathy, progression was associated with older age, male sex, hyperglycaemia (as evidenced by a higher HbA1c) and with not smoking.Conclusion/interpretation The findings re-emphasise the need for good glycaemic control and assiduous treatment of hypertension if diabetic retinopathy is to be minimised.
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IV iron may outperform oral iron replacement.
“Iron given intravenously may produce better results than oral replacement.”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [484]
The Subjects and methods and Discussion passages concern glucose-control treatments and diabetic retinopathy, not iron replacement. Searches for intravenous versus oral iron and iron-deficiency treatment found no passage comparing the two; page numbers were unavailable in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredVitamin D2 or D3 supplementation may lower PTH in CKD with secondary hyperparathyroidism.
“Supplementing vitamin D2 or D3 may reduce PTH in persons with CKD and secondary hyperparathyroidism.484,485”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [484]
The Discussion describes glycaemic control and diabetic retinopathy in people with type II diabetes, not PTH reduction in people with CKD. Searches for vitamin D2/D3 supplementation and for parathyroid hormone in CKD found no passage addressing the claim; the copy provides neither support nor a contrary finding. Page numbers were not available in the indexed passages. (LLM, conf=0.78)
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- Authors
- Stratton, I. M., Kohner, E. M., Aldington, S. J., Turner, R. C., Holman, R. R., Manley, S. E., & Matthews, D. R.
- Affiliations
- University of Oxford (GB)
- St Thomas' Hospital (GB)
- Imperial College London (GB)
- Oxford Centre for Diabetes, Endocrinology and Metabolism (GB)
- Venue
- Diabetologia
- Published
- 2001-02-05
- Volume
- 44
- Issue
- 2
- Pages
- 156-163
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2072690677
- Cited by
- 1,019
- References
- 10
- Citations by year
- 2026: 27 · 2025: 40 · 2024: 46 · 2023: 46 · 2022: 47 · 2021: 61 · 2020: 54 · 2019: 43 · 2018: 45 · 2017: 53 · 2016: 55 · 2015: 45 · 2014: 48 · 2013: 43 · 2012: 39
- FWCI
- 23.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- British Heart Foundation
- National Institutes of Health
- Medical Research Council
- St. George's, University of London
- National Eye Institute (2 UO1 EY07049-09)
- 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
- diabetic retinopathy, type 2 diabetes, retinopathy incidence, retinopathy progression, risk factors, glycemic control, HbA1c, blood pressure, smoking, microaneurysms, vitreous hemorrhage, photocoagulation, UKPDS
- MeSH terms
- Age Factors, Blood Glucose, Blood Pressure, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Female, Glycated Hemoglobin, Humans, Hypertension, Male, Middle Aged, Prospective Studies, Risk Factors, Sex Factors, Smoking, Time Factors
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