Biomedical and Psychiatric Risk Factors for Retinopathy Among Children With IDDM
| العنوان: | Biomedical and Psychiatric Risk Factors for Retinopathy Among Children With IDDM |
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| المؤلفون: | Maria Kovacs, Satish Iyengar, Protap Mukerji, Allan L. Drash |
| المصدر: | Diabetes Care. 18:1592-1599 |
| بيانات النشر: | American Diabetes Association, 1995. |
| سنة النشر: | 1995 |
| مصطلحات موضوعية: | Adult, Blood Glucose, Male, Longitudinal study, medicine.medical_specialty, Pediatrics, Time Factors, Adolescent, Endocrinology, Diabetes and Metabolism, Sex Factors, Risk Factors, Internal Medicine, medicine, Humans, Age of Onset, Risk factor, Young adult, Child, Depression (differential diagnoses), Glycemic, Glycated Hemoglobin, Advanced and Specialized Nursing, Sex Characteristics, Diabetic Retinopathy, Depression, business.industry, Age Factors, Diabetic retinopathy, medicine.disease, Surgery, Diabetes Mellitus, Type 1, Psychotic Disorders, Regression Analysis, Female, business, Psychosocial, Retinopathy |
| الوصف: | OBJECTIVE Illness duration and glycemic control influence the development of retinopathy in childhood-onset insulin-dependent diabetes mellitus (IDDM). Psychiatric disorders and sociodemographic factors also affect diabetes-related outcomes. However, biomedical and psychosocial factors have not been examined together in modeling the risk of retinopathy. RESEARCH DESIGN AND METHODS We conducted a single-site prospective longitudinal study of 66 children (aged 8-13 years) newly diagnosed with IDDM. Repeated assessments served to derive psychiatric diagnoses. Poor glycemic control was defined as the upper 15th percentile of all HbA1 values. After a median follow-up of 10 years, severity of retinopathy was determined. It was modeled with a stepwise polychotomous regression procedure using antecedent biomedical and psychosocial variables. RESULTS Young adults with childhood-onset IDDM were found to be at increased risk of retinopathy the longer they had IDDM, the more persistently they evidenced poor antecedent glycemic control, and the longer they suffered from depressive illness. These three factors operated individually and additively, with duration of IDDM conferring a baseline level of risk. In depressed patients (27%), depression onset antedated the detection of retinopathy generally by 7 years. CONCLUSIONS Duration of childhood-onset IDDM confers a baseline level of risk of retinopathy irrespective of glycemic control; antecedent clinical depression is also a risk factor. Depression therefore may serve as a marker of vulnerability and help to identify a subgroup of patients at risk for complications. The findings raise the question whether timely treatment of depression could forestall diabetic retinopathy. |
| تدمد: | 1935-5548 0149-5992 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::62cdbe770f55121b9c5667902d26bab9 https://doi.org/10.2337/diacare.18.12.1592 |
| رقم الأكسشن: | edsair.doi.dedup.....62cdbe770f55121b9c5667902d26bab9 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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