Duration (yr)

Fig. 6. The 4-yr progression of retinopathy by duration of diabetes by persons with good glycemic control (first quartile of glycosylated hemoglobin, 5.4-8.1%) vs those with poor glycemic control (fourth quartile of glycosylated hemoglobin, 10.9-20.8%) at baseline in persons with older onset type 2 diabetes in the Wisconsin Epidemiologic Study of Diabetic Retinopathy, 1980-1982 to 1984-1986.

wrote: "The extent to which hyperglycemia determines the risk of retinopathy is not at all clear. This is the most important issue at hand and deserves high priority in epidemiologic research" (49). Over the next 25 yr, data from epidemiological studies consistently demonstrated an association between glycemic control and the incidence and progression of diabetic retinopathy (21,29-32,50-60). Data from the WESDR showed that lower glycosylated hemoglobin at any stage of retinopathy before the proliferative phase and at any duration of diabetes was associated with lower 4-yr incidence and progression of retinopathy (Figs. 5-8) (21,27,60). However, randomized clinical trials were necessary because epidemiological studies could not assess whether the underlying severity of the diabetes independently led to both poorer glycemic control and more severe retinopathy.

Data from the DCCT, a large randomized controlled clinical trial of more than 1400 patients with type 1 diabetes showed that those assigned to intensive glycemic control

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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