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The prognosis for diabetes.

D R Hadden, J A Weaver

    Postgraduate Medical Journal
    |January 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

    Diabetic complications differ by onset type: juvenile-onset diabetes primarily affects small blood vessels, while adult-onset diabetes involves large vessel disease. Low HDL cholesterol may impact long-term outcomes in adult-onset diabetes.

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    Area of Science:

    • Endocrinology
    • Ophthalmology
    • Cardiovascular Medicine

    Background:

    • Diabetic complications vary significantly based on the age of onset.
    • Juvenile-onset diabetes (Type 1) predominantly leads to microvascular issues later in life.
    • Maturity-onset diabetes (Type 2) is associated with large vessel atheroma in long-term survivors.

    Purpose of the Study:

    • To differentiate the long-term vascular complications in juvenile-onset versus maturity-onset diabetes.
    • To estimate the prevalence of severe diabetic retinopathy requiring specialized treatment.
    • To explore metabolic factors influencing prognosis in maturity-onset diabetes.

    Main Methods:

    • Analysis of patient data from a diabetic-eye clinic.
    • Estimation of the percentage of patients with severe diabetic retinopathy.

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  • Review of long-term visual prognosis in treated patients.
  • Investigation of metabolic factors, including HDL cholesterol, in relation to vascular disease.

    • Main Results:

    • Microvascular disease is characteristic of juvenile-onset diabetes after 30 years.
    • Large vessel atheroma is a primary concern for long-term maturity-onset diabetic survival.
    • Approximately 3% of hospital diabetic clinic patients have severe diabetic retinopathy needing photocoagulation.
    • The long-term visual prognosis for treated patients is still under evaluation.

    Conclusions:

    • The pattern of vascular complications in diabetes is age-dependent.
    • Severe diabetic retinopathy requiring intervention is relatively rare.
    • Low HDL cholesterol may be a significant factor in the future prognosis of maturity-onset diabetes.