THE PREVALENCE AND SEVERITY OF MICROVASCULAR COMPLICATIONS IN PANCREATIC DIABETES AND IDDM

OBJECTIVE-To investigate and compare the prevalence, associations, and severity of retinopathy and nephropathy in patients with pancreatic d iabetes (PD) and insulin-dependent diabetes mellitus (IDDM). RESEARCH DESIGN AND METHODS-Thirty patients with PD due to alcohol-induced chro nic pancreatitis were matched for age, sex, and duration of diabetes w ith 30 patients with IDDM. Retinopathy was assessed by fluorescein ang iography using the Wisconsin classification. Renal function was assess ed by albumin excretion rates (AERs) in at least two timed overnight u rine collections and glomerular filtration rates (GFRs) by single inje ction of Cr-51-EDTA. Microalbuminuria was defined as AER 20-200 mu g/m in and nephropathy as AER > 200 mu g/min. RESULTS-Retinopathy was foun d in 33% of patients with PD and in 40% with IDDM. The spectrum of dis ease was similar in the two groups. The geometric mean of AER was 15 m u g/min (range 1-1,541) in the PD group and 24 mu g/min (2-2,288) in t he IDDM group. Nephropathy was found in 7 PD and in 5 IDDM patients, a nd a reduced GFR was present in 8 (26%) and 4 (13%) of the two groups, respectively. Microalbuminuria occurred in 9 (33%) and hyperfiltratio n in 3 (10%) in each group. These differences were insignificant. Reti nopathy correlated with AER in both groups. Retinopathy and AER correl ated with duration of diabetes in the IDDM but not in the PD group. CO NCLUSIONS-Microvascular complications are equally common and severe in PD and IDDM, and improved glycemic control should be the goal in both .