UK PROSPECTIVE DIABETES STUDY-22 - EFFECT OF AGE AT DIAGNOSIS ON DIABETIC TISSUE-DAMAGE DURING THE FIRST 6 YEARS OF NIDDM

OBJECTIVE - To assess the effect of age at diagnosis on the initial pr evalence and subsequent risk of the progression of diabetic tissue dam age in patients with NIDDM. RESEARCH DESIGN AND METHODS - The prevalen ce of Q-wave myocardial infarction, absent dorsalis pedis pulses, reti nopathy, absent ankle jerks, hypertension, and microalbuminuria were d etermined at baseline and at 3 and 6 years of follow-up in five consec utive g-year age-cohorts bf 3,027 newly diagnosed white patients aged between 36 and 65 years recruited to the U.K. Prospective Diabetes Stu dy. The effect of age at diagnosis on the initial prevalence and the r isk of progression of these complications and associated conditions wa s analyzed using logistic regression and proportional odds methods, re spectively RESULTS - Q-wave myocardial infarction and hypertension wer e more prevalent in older patients at presentation, but age at diagnos is did not have a significant effect on the increased risk of either a fter 6 years of NIDDM. Absent dorsalis pedis pulses and ankle jerks we re also more prevalent in the older age-groups at presentation, but ag e at diagnosis was a significant predictor of the increasing prevalenc e of both during follow-up. The baseline prevalence of retinopathy and microalbuminuria was not related to age. The subsequent risk of retin opathy, but not microalbuminuria, increased significantly with age at diagnosis. CONCLUSIONS - Age at diagnosis has a variable impact on dif ferent types of diabetic tissue damage and may thus be an important va riable in epidemiological and intervention studies in NIDDM. Regular o phthalmologic surveillance and examination of the feet increase in imp ortance with increasing age since the diagnosis of NIDDM.