RETINOPATHY AND NEPHROPATHY IN 772 INSULIN-TREATED DIABETIC-PATIENTS IN RELATION TO THE TYPE OF DIABETES

Using the register of the centralized Diabetes Care system in former GDR as run until 1989, the frequency of diabetic retinopathy and nephropathy and related factors were investigated in insulin-treated diabetic patients. Retinopathy was diagnosed by ophtalmoscopy, nephropathy was evaluated on the estimation of macroproteinuria. Out of the total of 1058 insulin-treated patients, 772 subjects (286 males, 486 females) who had undergone ophtalmoscopic examination during the previous year were selected for this study. According to clinical criteria, there were 238 patients with Type 1 and 534 patients with Type 2 diabetes. Their mean age was 43.3 and 64.5 years, respectively, and duration of diabetes was 13.2 and 14.0 years. Essential results: (1) Retinopathy was diagnosed in 52.5 % of Type 1 and in 50.3 % of insulin-treated Type 2 diabetic patients. There were no differences in the degree of retinopathy between the two groups. (2) The Type 1 diabetic patients with retinopathy were significantly older than those without retinopathy (49 vs. 37 years), but no such difference could be ascertained in Type 2 diabetes (64 vs. 65 years). (3) Duration of diabetes was longer in patients with retinopathy both in Type 1 (18 vs. 8 years) and in Type 2 diabetes (16 vs. 12 years). (4) Subjects of either group with retinopathy exhibited significantly higher systolic blood pressure values. (5) There was no difference in postprandial blood sugar or in applied insulin doses between the patients with or without retinopathy. (6) Clinical nephropathy was more frequent in Type 2 (22 %) than in Type 1 diabetes (16.3 %). These results indicate the importance of microangiopathic complications not only in Type 1 but also in Type 2 diabetic patients.