FACTORS MODIFYING THE EFFECT OF HYPERGLYCEMIA ON THE DEVELOPMENT OF RETINOPATHY IN ADOLESCENTS WITH DIABETES - RESULTS OF THE BERLIN RETINOPATHY STUDY

The Berlin Retinopathy Study follows children from the onset of diabet es with serial retinal examinations by fluorescein angiography. It con firmed that longterm poor glycemic control, both before and after pube rty, is the major risk factor for the development of retinal changes. The relationship between longterm HbAlc and background retinopathy fol lows an exponential, non-linear function. Apart from glycemia, several other factors (age at onset, puberty, lipids, blood pressure, genetic factors, smoking) may be of varying relevance in the individual patie nt. Nevertheless, best glycemic control from the onset of diabetes app ears to be of outstanding importance as the HbAlc levels already durin g the first year of diabetes are related to the later development of b ackground retinopathy.