Cumulative glycaemia as measured by lens fluorometry: association with retinopathy in type 2 diabetes

TY - JOUR

T1 - Cumulative glycaemia as measured by lens fluorometry: association with retinopathy in type 2 diabetes

AU - Munch, I C

AU - Larsen, M

AU - Borch-Johnsen, Knut

AU - Glümer, C

AU - Lund-Andersen, H

AU - Kessel, L

PY - 2011/4/1

Y1 - 2011/4/1

N2 - Aims/hypothesis: The aim of this study was to assess the association between lifelong cumulative glycaemia estimated by lens fluorometry and the presence of retinopathy in individuals with type 2 diabetes. Methods: We carried out a cross-sectional population-based study of 970 participants aged between 30 and 60 years, of which 170 were diagnosed with diabetes on screening (WHO 1999 criteria) and 35 had known type 2 diabetes. Procedures included clinical and laboratory examinations, non-invasive assessment of the intrinsic fluorescence of the lens of the eye, and seven-field fundus photography. Results: Retinopathy was found in 46 (22%) of 205 participants with type 2 diabetes. In a logistic regression analysis controlling for age, sex and diabetes status (screen-detected or known), a two-fold increase in lens fluorescence increased the odds for retinopathy by 3.46 (95% CI 1.25-9.55, p=0.017). The association was marginally significant (OR 3.00 [95% CI 1.00-9.01], p=0.050) when also adjusted for smoking, systolic blood pressure, body mass index and HbA1c. Conclusions/interpretation: Diabetic retinopathy was related to cumulative lifelong glycaemia as estimated by lens fluorometry in participants with type 2 diabetes. This supports the hypothesis that retinopathy is a marker of lifelong elevated glycaemia as well as of the unknown, pre-diagnostic duration of type 2 diabetes. The powerful association between lens fluorescence and retinopathy underscores the importance of strict long-term glycaemic control in the prevention of retinopathy in people with diabetes.

AB - Aims/hypothesis: The aim of this study was to assess the association between lifelong cumulative glycaemia estimated by lens fluorometry and the presence of retinopathy in individuals with type 2 diabetes. Methods: We carried out a cross-sectional population-based study of 970 participants aged between 30 and 60 years, of which 170 were diagnosed with diabetes on screening (WHO 1999 criteria) and 35 had known type 2 diabetes. Procedures included clinical and laboratory examinations, non-invasive assessment of the intrinsic fluorescence of the lens of the eye, and seven-field fundus photography. Results: Retinopathy was found in 46 (22%) of 205 participants with type 2 diabetes. In a logistic regression analysis controlling for age, sex and diabetes status (screen-detected or known), a two-fold increase in lens fluorescence increased the odds for retinopathy by 3.46 (95% CI 1.25-9.55, p=0.017). The association was marginally significant (OR 3.00 [95% CI 1.00-9.01], p=0.050) when also adjusted for smoking, systolic blood pressure, body mass index and HbA1c. Conclusions/interpretation: Diabetic retinopathy was related to cumulative lifelong glycaemia as estimated by lens fluorometry in participants with type 2 diabetes. This supports the hypothesis that retinopathy is a marker of lifelong elevated glycaemia as well as of the unknown, pre-diagnostic duration of type 2 diabetes. The powerful association between lens fluorescence and retinopathy underscores the importance of strict long-term glycaemic control in the prevention of retinopathy in people with diabetes.

U2 - 10.1007/s00125-010-2023-2

DO - 10.1007/s00125-010-2023-2

M3 - Journal article

C2 - 21190013

SN - 0012-186X

VL - 54

SP - 757

EP - 761

JO - Diabetologia

JF - Diabetologia

IS - 4

ER -