We studied the association between retinopathy and glucose metabolism
in a population-based study of elderly men and women, Glucose metaboli
sm was assessed by serum fructosamine and a nonfasting oral glucose to
lerance test, and retinopathy was evaluated by fundus photography, Ret
inopathy was present in 296 of 6,191 subjects examined (4.8%; 120 men
and 176 women), Serum glucose and fructosamine levels were higher in s
ubjects with retinopathy compared with those without (8.4 vs, 6.8 mmol
/l and 329.8 vs, 308.5 mu mol/l, respectively, P < 0.001). Two-hour po
stload insulin levels and insulin resistance, assessed by the ratio of
postload insulin over postload glucose level, did not differ between
the two groups, These associations were similar in men and women and i
n subjects with and without diabetes and did not change after adjustme
nt for body mass index or systolic blood pressure, Within the group of
subjects who had retinopathy, serum glucose was significantly associa
ted with the number of hemorrhages, These findings suggest that the pr
esence and severity of retinopathy are associated with higher serum gl
ucose levels, both in subjects with and without diabetes.