Ramachandran A, Snehalatha C, Vijay V, Viswanathan M
Diabetes Research Centre, Royapuram, Madras, India.
Diabetes Res Clin Pract. 1996 Apr;32(1-2):111-4. doi: 10.1016/0168-8227(96)01185-0.
Several studies from the U.K. and the U.S. have shown that retinopathy was present at diagnosis of non-insulin dependent diabetes mellitus (NIDDM) indicating the likelihood of a latent phase of hyperglycaemia for a long period. This study looked for the prevalence of retinopathy at diagnosis of NIDDM in South Indian subjects who have a fairly high prevalence of diabetes and also a high rate of undetected diabetes. One thousand NIDDM subjects with varying duration of diabetes underwent detailed ophthalmoscopic examination for retinopathy. It was noted that the prevalence of retinopathy increased linearly with duration of diabetes. Among the 60 newly diagnosed NIDDM, 4 (6.7%) subjects had background diabetic retinopathy. Using a weighted linear regression analysis with percentage of retinopathy in relation to duration, it was estimated that hyperglycaemia could have been present 4.1 years prior to the diagnosis of NIDDM. Although the prevalence of retinopathy at diagnosis in South Indian NIDDM was lower than the other reported values, in view of the high prevalence of diabetes in Indians, a large number of patients would have the risk of microangiopathy even before diagnosis of diabetes is made.
英国和美国的多项研究表明,非胰岛素依赖型糖尿病(NIDDM)确诊时就存在视网膜病变,这表明高血糖的潜伏期可能很长。本研究旨在寻找南印度人群中NIDDM确诊时视网膜病变的患病率,该地区糖尿病患病率相当高,未被检测出的糖尿病发病率也很高。1000名患有不同病程糖尿病的NIDDM患者接受了详细的眼底镜检查以诊断视网膜病变。结果发现,视网膜病变的患病率随糖尿病病程呈线性增加。在60名新确诊的NIDDM患者中,4名(6.7%)患有背景性糖尿病视网膜病变。使用加权线性回归分析视网膜病变百分比与病程的关系,估计在NIDDM确诊前4.1年就可能已存在高血糖。尽管南印度NIDDM患者确诊时视网膜病变的患病率低于其他报告值,但鉴于印度糖尿病的高患病率,即使在糖尿病确诊之前,大量患者也有微血管病变的风险。