Systolic hypertension and duration of diabetes mellitus are important determinants of retinopathy and microalbuminuria in young diabetics

This cross-sectional study looked at the prevalence of microalbuminuria and retinopathy in a cohort of 926 young, Type 1 and Type 2 diabetes mellitus (DM) patients, and determined the factors which were associated with these microvascular complications. The prevalence of microalbuminuria, defined as the albumin:creatinine ratio greater than or equal to 2.5 (for males) or g reater than or equal to 3.5 mg/mmol (for females), was 13.4% in Type 1 DM, 69.5% in insulin-requiring Type 2 DM and 16% in Type 2 DM treated only with oral hypoglycemic agents. Compared to those with normal renal functions, t hese patients were older (P less than or equal to 0.01), had significantly elevated blood pressures (P < 0.01 or P = 0.0001), and in the case of Type 1 DM, with a higher body mass index (P = 0.0001) and waist-hip ratio (P < 0 .01). The prevalence of diabetic retinopathy in Type 1 DM was found to incr ease with the duration of diabetes, from 1.4% in the newly-onset (< 5 years ), to 9.9% in those with 5-10 years disease, to 35% among patients with mor e than 10 years of diabetes (P < 0.0001). In this study, it was also observ ed that 10% of the Type 1 DM patients already had retinopathy within 5 year s of diagnosis, and the prevalence increased significantly to 42.9% (P < 0. 0001) among patients who had been diabetics for more than 10 years. Stepwis e multiple regression analysis showed that besides the disease duration, sy stolic blood pressure was the most common and significant determinant for b oth microalbuminuria and retinopathy in both types of DM, thus implying tha t in order to reduce the risk of microvascular complications in diabetes me llitus, systolic and not just the diastolic blood pressure, should be effec tively controlled. (C) 1999 Elsevier Science Iceland Ltd. All rights reserv ed.