Background
Methods
Study population
Ophthalmologic examination
Assessments
Definitions
Assays
Statistical analysis
Test of difference in level of logMAR at diabetes diagnosis a
| Test of difference in change of logMAR after diabetes diagnosis b
| |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Characteristic at diagnosis | Category |
n
| Average logMAR at diabetes diagnosis | Average yearly change in logMAR after diabetes diagnosis | Un-adjusted
p
| Age and sex adjusted
p
| Un-adjusted
p
| Age and sex adjusted
p
| Median decimal acuity at diabetes diagnosis | Median decimal acuity 5.6 years after diabetes diagnosis |
Total
|
1241
|
-0.24
|
-0.0250
|
1.00 (0.80-1.00)
|
0.80 (0.67-1.00)
| |||||
Sex | Female | 588 | -0.30 | -0.0343 | 0.001 | 0.070 | 0.0006 | 0.017 | 0.90 (0.67-1.00) | 0.80 (0.60-1.00) |
Male | 653 | -0.19 | -0.0160 | 1.00 (0.80-1.00) | 1.00 (0.67-1.00) | |||||
Age (years) | 40- < 60 | 430 | -0.05 | -0.0068 | < 0.0001 | < 0.0001 | < 0.0001 | < 0.0001 | 1.00 (1.00-1.00) | 1.00 (0.80-1.00) |
60- < 70 | 377 | -0.18 | -0.0125 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) | |||||
≥ 70 | 434 | -0.47 | -0.0769 | 0.70 (0.60-0.95) | 0.60 (0.40-0.80) | |||||
Living alone | Yes | 384 | -0.39 | -0.0527 | < 0.0001 | 0.0009 | < 0.0001 | 0.002 | 0.80 (0.67-1.00) | 0.67 (0.50-0.90) |
No | 835 | -0.17 | -0.0158 | 1.00 (0.80-1.00) | 1.00 (0.70-1.00) | |||||
Education | Basic | 935 | -0.26 | -0.0293 | 0.006 | 0.67 | 0.008 | 0.30 | 1.00 (0.70-1.00) | 0.80 (0.60-1.00) |
Higher | 252 | -0.15 | -0.0114 | 1.00 (0.90-1.00) | 1.00 (0.70-1.00) | |||||
Residence | Countryside | 486 | -0.26 | -0.0269 | 0.41 | 0.98 | 0.56 | 0.60 | 1.00 (0.80-1.00) | 0.80 (0.63-1.00) |
Larger towns | 430 | -0.24 | -0.0211 | 1.00 (0.80-1.00) | 0.80 (0.63-1.00) | |||||
Copenhagen area | 273 | -0.20 | -0.0211 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) | |||||
Familial disposition to DM | No | 659 | -0.25 | -0.0314 | 0.58 | 0.76 | 0.041 | 0.028 | 1.00 (0.75-1.00) | 0.80 (0.63-1.00) |
Yes | 466 | -0.23 | -0.0195 | 1.00 (0.80-1.00) | 0.90 (0.67-1.00) | |||||
Diagnostic plasma glucose (mmol/l) | < 10 | 220 | -0.23 | -0.0227 | 0.93 | 0.47 | 0.36 | 0.063 | 1.00 (0.80-1.00) | 0.80 (0.63-1.00) |
10-< 17 | 706 | -0.24 | -0.0281 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) | |||||
≥ 17 | 315 | -0.24 | -0.0193 | 1.00 (0.80-1.00) | 0.80 (0.60-1.00) | |||||
Haemoglobin A1c (%) c
| < 9 | 298 | -0.20 | -0.0239 | 0.45 | 0.35 | 0.083 | 0.071 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) |
9- < 11 | 347 | -0.24 | -0.0347 | 1.00 (0.80-1.00) | 0.90 (0.67-1.00) | |||||
≥ 11 | 396 | -0.25 | -0.0195 | 1.00 (0.70-1.00) | 0.80 (0.60-1.00) | |||||
Total cholesterol (mmol/l) | < 6 | 495 | -0.27 | -0.0190 | 0.22 | 0.55 | 0.20 | 0.076 | 1.00 (0.70-1.00) | 0.80 (0.60-1.00) |
6-< 7 | 366 | -0.24 | -0.0297 | 1.00 (0.80-1.00) | 0.90 (0.67-1.00) | |||||
≥ 7 | 358 | -0.20 | -0.0277 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) | |||||
Fasting triglycerides (mmol/l) | < 2 | 616 | -0.24 | -0.0201 | 0.89 | 0.75 | 0.022 | 0.0008 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) |
2- < 3 | 320 | -0.25 | -0.0227 | 1.00 (0.80-1.00) | 0.80 (0.60-1.00) | |||||
≥ 3 | 279 | -0.23 | -0.0388 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) | |||||
Urinary albumin (mg/l) | < 15 | 703 | -0.19 | -0.0205 | 0.004 | 0.015 | 0.038 | 0.13 | 1.00 (0.80-1.00) | 0.90 (0.67-1.00) |
15-< 200 | 437 | -0.31 | -0.0347 | 1.00 (0.70-1.00) | 0.80 (0.60-1.00) | |||||
≥ 200 | 59 | -0.21 | -0.0172 | 1.00 (0.80-1.00) | 0.80 (0.60-1.00) | |||||
Serum creatinine (μmol/l) | < 130 | 1166 | -0.23 | -0.0238 | 0.012 | 0.33 | 0.012 | 0.062 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) |
≥ 130 | 54 | -0.43 | -0.0634 | 0.80 (0.67-1.00) | 0.75 (0.50-1.00) | |||||
Height - men (cm) | < 165 | 69 | -0.30 | -0.0273 | 0.11 | 0.58 | 0.53 | 0.96 | 0.95 (0.70-1.00) | 0.80 (0.60-1.00) |
165- < 180 | 470 | -0.18 | -0.0156 | 1.00 (0.80-1.00) | 1.00 (0.67-1.00) | |||||
≥ 180 | 113 | -0.14 | -0.0135 | 1.00 (0.90-1.00) | 1.00 (0.80-1.00) | |||||
Height - women (cm) | < 150 | 19 | -0.47 | -0.0587 | 0.050 | 0.47 | 0.12 | 0.91 | 0.70 (0.70-0.80) | 0.60 (0.50-0.80) |
150- < 165 | 415 | -0.32 | -0.0390 | 0.80 (0.67-1.00) | 0.80 (0.50-1.00) | |||||
≥ 165 | 154 | -0.20 | -0.0203 | 1.00 (0.80-1.00) | 0.90 (0.70-1.00) | |||||
Systolic blood pressure (mm Hg) | < 140 | 366 | -0.18 | -0.0174 | 0.023 | 0.78 | 0.036 | 0.63 | 1.00 (0.80-1.00) | 1.00 (0.67-1.00) |
140-< 160 | 414 | -0.25 | -0.0223 | 1.00 (0.70-1.00) | 0.80 (0.63-1.00) | |||||
≥ 160 | 459 | -0.28 | -0.0338 | 1.00 (0.75-1.00) | 0.80 (0.62-1.00) | |||||
Resting heart rate (bpm) | < 80 | 754 | -0.23 | -0.0208 | 0.17 | 0.09 | 0.040 | 0.066 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) |
80- < 90 | 333 | -0.23 | -0.0361 | 1.00 (0.70-1.00) | 0.80 (0.60-1.00) | |||||
≥ 90 | 149 | -0.32 | -0.0219 | 1.00 (0.67-1.00) | 0.80 (0.63-1.00) | |||||
Cardiovascular disease | No | 849 | -0.20 | -0.0224 | < 0.0001 | 0.045 | 0.035 | 0.55 | 1.00 (0.80-1.00) | 0.90 (0.67-1.00) |
Yes | 367 | -0.34 | -0.0357 | 0.90 (0.67-1.00) | 0.80 (0.50-1.00) | |||||
Peripheral neuropathy | No | 992 | -0.22 | -0.0218 | 0.013 | 0.14 | 0.013 | 0.016 | 1.00 (0.80-1.00) | 0.90 (0.67-1.00) |
Yes | 232 | -0.32 | -0.0392 | 0.90 (0.67-1.00) | 0.80 (0.60-1.00) | |||||
Self-rated health | Excellent or good | 557 | -0.18 | -0.0200 | 0.0006 | 0.003 | 0.043 | 0.13 | 1.00 (0.80-1.00) | 0.90 (0.70-1.00) |
Fair, poor or very poor | 663 | -0.29 | -0.0309 | 0.90 (0.70-1.00) | 0.80 (0.60-1.00) | |||||
Smoking | Never | 372 | -0.33 | -0.0369 | 0.0007 | 0.32 | 0.009 | 0.50 | 0.90 (0.67-1.00) | 0.80 (0.60-1.00) |
Former | 431 | -0.22 | -0.0206 | 1.00 (0.80-1.00) | 0.80 (0.63-1.00) | |||||
Current | 414 | -0.18 | -0.0186 | 1.00 (0.80-1.00) | 1.00 (0.70-1.00) | |||||
Physical activity | Sedentary | 323 | -0.39 | -0.0364 | < 0.0001 | < 0.0001 | 0.035 | 0.20 | 0.80 (0.60-1.00) | 0.70 (0.50-1.00) |
Non-sedentary | 893 | -0.19 | -0.0227 | 1.00 (0.80-1.00) | 0.90 (0.67-1.00) | |||||
Weight - men (kg) | < 80 | 200 | -0.24 | -0.0172 | 0.19 | 0.85 | 0.64 | 0.81 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) |
80- < 90 | 196 | -0.18 | -0.0204 | 1.00 (0.80-1.00) | 1.00 (0.80-1.00) | |||||
≥ 90 | 255 | -0.16 | -0.0130 | 1.00 (0.80-1.00) | 1.00 (0.70-1.00) | |||||
Weight - women (kg) | < 70 | 200 | -0.39 | -0.0485 | 0.008 | 0.21 | 0.040 | 0.068 | 0.80 (0.67-1.00) | 0.70 (0.50-1.00) |
70-< 80 | 157 | -0.29 | -0.0208 | 0.90 (0.67-1.00) | 0.80 (0.60-1.00) | |||||
≥ 80 | 231 | -0.21 | -0.0319 | 1.00 (0.80-1.00) | 0.80 (0.63-1.00) | |||||
Diabetic retinopathy | None | 1186 | -0.23 | -0.0243 | 0.040 | 0.012 | < 0.0001 | 0.0005 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) |
Microaneurysms only | 14 | -0.54 | 0.0174 | 1.00 (0.90-1.00) | 0.85 (0.80-1.00) | |||||
Further retinopathy | 38 | -0.38 | -0.1164 | 0.80 (0.63-1.00) | 0.60 (0.50-0.80) | |||||
Age-related macular degeneration | No | 1087 | -0.18 | -0.0170 | < 0.0001 | < 0.0001 | < 0.0001 | < 0.0001 | 1.00 (0.80-1.00) | 0.90 (0.67-1.00) |
Yes | 154 | -0.67 | -0.1000 | 0.67 (0.50-0.80) | 0.50 (0.40-0.67) | |||||
Cataract | No | 889 | -0.14 | -0.0145 | < 0.0001 | < 0.0001 | < 0.0001 | 0.0004 | 1.00 (0.80-1.00) | 1.00 (0.70-1.00) |
Yes | 337 | -0.51 | -0.0698 | 0.70 (0.50-0.80) | 0.60 (0.50-0.80) | |||||
Other retinopathy | No | 1129 | -0.23 | -0.0239 | 0.32 | 0.87 | 0.18 | 0.93 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) |
Yes | 112 | -0.29 | -0.0370 | 0.80 (0.67-1.00) | 0.67 (0.50-1.00) | |||||
Eye pressure (mmHg) | < 16 | 369 | -0.25 | -0.0215 | 0.58 | 0.64 | 0.031 | 0.045 | 1.00 (0.70-1.00) | 0.90 (0.67-1.00) |
16- < 20 | 592 | -0.22 | -0.0234 | 1.00 (0.80-1.00) | 0.80 (0.67-1.00) | |||||
≥ 20 | 151 | -0.28 | -0.0441 | 1.00 (0.75-1.00) | 0.80 (0.60-1.00) |
Results
Baseline characteristics
Visual acuity a
| ||||
---|---|---|---|---|
Normal | Moderately impaired | Blind | All patients | |
n = 1,163 |
n = 67 |
n = 11 |
n = 1,241 | |
Age (years) | ||||
40- < 60 | 429 (36.9) | 1 (1.5) | 0 (0) | 430 (34.7) |
60- < 70 | 366 (31.5) | 10 (14.9) | 1 (9.1) | 377 (30.4) |
70+ | 368 (31.6) | 56 (83.6) | 10 (90.9) | 434 (35.0) |
Sex | ||||
Male | 622 (53.5) | 28 (41.8) | 3 (27.3) | 653 (52.6) |
Female | 541 (46.5) | 39 (58.2) | 8 (72.7) | 588 (47.4) |
Retinopathy a
| ||||
Diabetic retinopathy | ||||
Microaneurysms only | 13 (1.1) | 0 (0) | 1 (9.1) | 14 (1.1) |
Further diabetic retinopathy | 34 (2.9) | 2 (3.0) | 2 (18.2) | 38 (3.1) |
Age-related macular degeneration, AMD | 117 (10.1) | 30 (44.8) | 7 (63.6) | 154 (12.4) |
Other | 104 (8.9) | 7 (10.5) | 1 (9.1) | 112 (9.0) |
No retinopathy | 908 (78.3) | 32 (47.8) | 1 (9.1) | 941 (76.0) |
Cataract a
| 278 (24.2) | 55 (82.1) | 4 (36.4) | 337 (27.5) |
Ophthalmologist's indication of reason for visual impairment a, b
| ||||
Retinopathy of all sorts | 76 (6.5) | 13 (19.4) | 5 (45.4) | 94 (7.6) |
Cataract | 171 (14.7) | 25 (37.3) | 1 (9.1) | 197 (15.9) |
Other causes | 42 (3.6) | 6 (9.0) | 2 (18.2) | 50 (4.0) |
Combination of causes | 45 (3.9) | 20 (29.9) | 2 (18.2) | 67 (5.4) |
None | 829 (71.3) | 3 (4.5) | 1 (9.1) | 833 (67.1) |
Change in visual acuity
Visual acuity at diagnosis a
| Visual acuity at 6-year follow up a
| |||
---|---|---|---|---|
Normal | Moderately impaired | Blind | Total | |
Normal | 720 (92.3) | 48 (6.2) | 12 (1.5) | 780 (96.7) |
Moderately impaired | 14 (56.0) | 5 (20.0) | 6 (24.0) | 25 (3.1) |
Blind | 0 (0) | 1 (50.0) | 1 (50.0) | 2 (0.2) |
Total | 734 (90.9) | 54 (6.7) | 19 (2.4) | 807 (100) |
Diabetic retinopathy at 6-year follow up a
| ||||||
---|---|---|---|---|---|---|
Diabetic retinopathy at diabetes diagnosis a
| No diabetic retinopathy | Background retinopathy | ||||
Microaneurysms only | Without maculopathy | With maculopathy | Proliferative retinopathy b
| Total | ||
No diabetic retinopathy | 680 (88.3) | 46 (6.0) | 32 (4.2) | 10 (1.3) | 2 (0.3) | 770 (96.0) |
Background retinopathy | ||||||
Microaneurysms only | 2 (20.0) | 3 (30.0) | 4 (40.0) | 1 (10.0) | 0 (0) | 10 (1.2) |
Without maculopathy | 8 (47.1) | 1 (5.9) | 3 (17.6) | 1 (5.9) | 4 (23.5) | 17 (2.1) |
With maculopathy | 0 (0) | 1 (20.0) | 0 (0) | 3 (60.0) | 1 (20.0) | 5 (0.6) |
Proliferative retinopathy | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Total | 690 (86.0) | 51 (6.4) | 39 (4.9) | 15 (1.9) | 7 (0.9) | 802 (100) |
Visual acuity a
| ||||
---|---|---|---|---|
Normal | Moderately impaired | Blind | All patients | |
Retinopathy a
|
n = 734 |
n = 54 |
n = 16 |
n = 804 |
Diabetic retinopathy | ||||
Microaneurysms only | 46 (6.3) | 5 (9.3) | 0 (0) | 51 (6.3) |
Further diabetic retinopathy b
| 48 (6.5) | 10 (18.5) | 3 (18.8) | 61 (7.6) |
Age-related macular degeneration, AMD | 65 (8.9) | 20 (37.0) | 11 (57.9) | 96 (11.9) |
Other retinopathy | 44 (6.0) | 0 (0) | 2 (10.5) | 46 (5.7) |
No retinopathy | 541 (73.7) | 23 (42.6) | 1 (6.3) | 565 (70.3) |