PMID- 23193204
OWN - NLM
STAT- MEDLINE
DCOM- 20130904
LR  - 20221207
IS  - 1935-5548 (Electronic)
IS  - 0149-5992 (Print)
IS  - 0149-5992 (Linking)
VI  - 36
IP  - 3
DP  - 2013 Mar
TI  - Assessing progress in retinopathy outcomes in type 1 diabetes: comparing findings 
      from the Wisconsin Diabetes Registry Study and the Wisconsin Epidemiologic Study 
      of Diabetic Retinopathy.
PG  - 631-7
LID - 10.2337/dc12-0863 [doi]
AB  - OBJECTIVE: The Wisconsin Diabetes Registry Study (WDRS) cohort consisted of 
      patients diagnosed with type 1 diabetes in the same geographic region as, but 
      8-34 years later than the Wisconsin Epidemiologic Study of Diabetic Retinopathy 
      (WESDR) cohort, providing a unique opportunity to assess changes in 
      complications. We estimated the current prevalence and severity of diabetic 
      retinopathy at 20 years of diabetes duration, compared these between eras, and 
      evaluated the influence of diabetes management. RESEARCH DESIGN AND METHODS: 
      Twenty-year examinations, including fundus photographs, were completed on 305 
      WDRS subjects during 2007-2011. A subgroup of the WESDR cohort participated in 
      one of four study visits during 1980-1996, at similar diabetes duration (n = 
      583). Adjusted ordinal logistic regression with three retinopathy severity 
      categories was used to estimate odds ratios (ORs) of more severe retinopathy with 
      diagnosis during an earlier era. RESULTS: Mean hemoglobin A(1c) (HbA(1c)) was 
      lower in WDRS than in WESDR (8.0% vs. 9.3% [P < 0.001], and 93.4% vs. 21.3% [P < 
      0.001]) used >/=3 daily insulin injections or an insulin pump. In WDRS, 18% had 
      vision-threatening levels of retinopathy vs. 43% in WESDR. The adjusted OR of 
      more severe retinopathy in the earlier era (OR 3.0 [95% CI 2.2-4.0]) was reduced 
      by including 20-year HbA(1c) in the model (OR 2.2 [1.6-3.0]). CONCLUSIONS: 
      Retinopathy severity at a diabetes duration of 20 years is lower in the more 
      recent era of type 1 diabetes. Updated projections should be used when informing 
      newly diagnosed individuals of prognosis and for health care cost assessments. 
      Current glycemic control explained a limited amount of the difference.
FAU - LeCaire, Tamara J
AU  - LeCaire TJ
AD  - Department of Population Health Sciences School of Medicine and Public Health, 
      University of Wisconsin, Madison, WI, USA.
FAU - Palta, Mari
AU  - Palta M
FAU - Klein, Ronald
AU  - Klein R
FAU - Klein, Barbara E K
AU  - Klein BE
FAU - Cruickshanks, Karen J
AU  - Cruickshanks KJ
LA  - eng
GR  - R01 DK036904/DK/NIDDK NIH HHS/United States
GR  - R01 EY016379/EY/NEI NIH HHS/United States
GR  - R01-DK036904/DK/NIDDK NIH HHS/United States
GR  - R01-EY016379/EY/NEI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20121127
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Adult
MH  - Diabetes Mellitus, Type 1/complications/*epidemiology/metabolism/*pathology
MH  - Diabetic Retinopathy/*epidemiology/etiology/metabolism/*pathology
MH  - Female
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Male
MH  - Registries
MH  - Wisconsin/epidemiology
MH  - Young Adult
PMC - PMC3579344
EDAT- 2012/11/30 06:00
MHDA- 2013/09/05 06:00
PMCR- 2014/03/01
CRDT- 2012/11/30 06:00
PHST- 2012/11/30 06:00 [entrez]
PHST- 2012/11/30 06:00 [pubmed]
PHST- 2013/09/05 06:00 [medline]
PHST- 2014/03/01 00:00 [pmc-release]
AID - dc12-0863 [pii]
AID - 0863 [pii]
AID - 10.2337/dc12-0863 [doi]
PST - ppublish
SO  - Diabetes Care. 2013 Mar;36(3):631-7. doi: 10.2337/dc12-0863. Epub 2012 Nov 27.