GOOD BLOOD-GLUCOSE CONTROL CHARACTERIZES PATIENTS WITHOUT RETINOPATHYAFTER LONG DIABETES DURATION

The importance of blood glucose control for the avoidance of retinopat hy was assessed by monitoring glycated haemoglobin for 5 years or more in Type 1 (insulin-dependent) diabetic patients diagnosed before an a ge of 31 years, and with a diabetes duration of 20 years or more. They were followed up for an average of 9.4 years with 3.3 measurements pe r year. Of the 213 included patients, 16 had no retinopathy, 126 had b ackground retinopathy (including 8 with macula oedema) and 71 had prol iferative retinopathy. Patients without retinopathy had a mean HbA(1c) +/- SEM for the whole follow-up period of 6.3 +/- 0.19 %, the 117 pat ients with background retinopathy but not macula oedema 7.0 +/- 0.08 % ; Mann-Whitney test vs group without retinopathy p = 0.003, macula oed ema 7.9 +/- 0.31 %; p = 0.001, and proliferative retinopathy 7.4 +/- 0 .09; p < 0.001. The mean duration was 31 years, without significant di fferences between the groups. In conclusion, these results suggests th at good blood glucose control is of major importance to prevent or pos tpone diabetic retinopathy also after long duration of diabetes, and t hat no patient with high HbA(1c) levels for several years is protected from retinopathic lesions.