INCIDENCE OF COMPLICATIONS IN INSULIN-DEPENDENT DIABETES-MELLITUS - ASURVIVAL ANALYSIS

The authors used 4-year incidence data from the Pittsburgh Epidemiolog y of Diabetes Complications (EDC) Study to investigate the wider appli cability of recent research findings that demonstrate an association b etween glycemic control and insulin-dependent diabetes mellitus (IDDM) complications, EDC subjects participated in a clinical examination at baseline (1986-1988) and were followed up every 2 years, Results demo nstrated that, during the first 4 years of follow-up, subjects who wer e in ''poor'' control (glycosylated hemoglobin (GHb) greater than or e qual to 11%) at baseline were significantly (p < 0.001) more likely to develop microalbuminuria, proliferative retinopathy, and distal symme trical polyneuropathy (DSP), compared with subjects who were in ''fair '' control (GHb < 11%), Subjects who were in poor control were somewha t more likely to develop overt nephropathy (p = 0.08) and renal failur e (p = 0.085) during follow-up; however, no associations were observed with either coronary heart disease or lower extremity arterial diseas e (LEAD), These results confirm the strong association between prior g lycemic control and the onset of microalbuminuria, proliferative retin opathy, and DSP observed in the Diabetes Control and Complications Tri al study. However, the results of the study suggest weaker association s for the later stages of renal disease, and little relation was seen between glycemic control and LEAD or coronary disease, Other risk fact ors may be more important for the development of the later complicatio ns of IDDM, Further follow-up is necessary in order to rule out type I I error.