EPIDEMIOLOGY OF LATE DIABETIC COMPLICATIONS: A Basis for the Development and Evaluation of Preventive Programs
Section snippets
Cumulative Incidence of Retinopathy According to Diabetes Duration
The most frequent late complication of IDDM is retinopathy. Following the onset of IDDM, there is a lag period of about 3 to 4 years before the first cases of nonproliferative retinopathy are seen.19, 53, 105 The risk then increases exponentially. During the fifth year of IDDM, nonproliferative retinopathy develops in 1 of 100 patients, whereas in the fourteenth year, it develops in 11 of 100 patients who have escaped it up to that time.3 By the fifteenth year of IDDM, the cumulative incidence
Cumulative Incidence of Diabetic Kidney Disease According to Diabetes Duration
The natural history of diabetic kidney disease has generally been viewed as a descending path from normoalbuminuria to end-stage renal disease through intermediate stages marked by microalbuminuria and then overt proteinuria.91The prevalence of these stages of diabetic kidney disease in IDDM is summarized according to the duration of diabetes in Figure 3Because several studies have demonstrated that the duration of diabetes before puberty does not contribute to the risk of diabetic kidney
DIABETES AND CORONARY ARTERY DISEASE
In contrast to ocular and renal complications, which occur in patients with diabetes in all populations, coronary artery disease is a frequent complication in diabetic patients mainly in populations in which there is a high risk of coronary artery disease in individuals without diabetes. The excess coronary artery disease in patients with diabetes in these populations is independent of the frequency and level of conventional risk factors for coronary artery disease.51, 123The following review
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Address reprint requests to Andrzej S. Krolewski, MD, PhD, Section of Epidemiology and Genetics, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215
Supported by National Institutes of Health grant RO1 41526
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From the Section of Epidemiology and Genetics, Research Division, Joslin Diabetes Center (all authors); the Department of Medicine, Harvard Medical School (ASK, MBSF); and the Department of Epidemiology, Harvard School of Public Health (ASK, JHW), Boston, Massachusetts