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R. Kawasaki, M. Tominaga, H. Yamashita; Evaluating criteria for the diagnosis of diabetes mellitus by prevalence of diabetic retinopathy . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5283.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Criteria for the diagnosis of diabetes mellitus is determined by threshold values of hyperglycemia which increase risk of diabetic retinopathy and other microvasucular complications. This study aims to evaluate the criteria with population–based data, the Funagata Diabetes Study, Japan, which was held in 2000 to 2002. Methods: All the residents in Funagata town, of the age over thirty–five years old, were encouraged to participate the Funagata diabetes study in Funagata, Japan, 2000–2002. N=1724 was enrolled into this study. General examination include 75g–OGTT(fasting plasma glucose(FPG) and 2–hour postprandial plasma glucose(2hPG)), hemoglobin A1c(HbA1c) and other general factors. Ocular fundus was photographed in one eye of each participant using a 45–degree nonmydriatic fundus camera. The subject who has diagnosed as diabetes mellitus previously were photographed both eyes. A masked grader evaluated the fundus photographs and determined retinopathy and other retinal abnormalities. Based on the results, the prevalence of retinopathy by deciles of the distribution of FPG, 2hPG and HbA1c to increase risk of retinopathy was examined.The value of each factors which maximize the risk of retinopathy were determined with reciever–operating characteristic (ROC) curve analysis. Results: Prevalence of retinopathy increased beyond the baseline level from the level of 104–113mg/dl with FPG, 131–145mg/dl with 2hPG, >5.7% with HbA1c. The value to maximize risk of retinopathy were 103mg/dl(sensitivity 43.9%, specificity 78.9%) with FPG and 5.8% (senseitivity 28.1%, specificity 92.6%) with HbA1c. View OriginalDownload SlideView OriginalDownload Slide Conclusions: According to the thresold level of increasing risk of retinopathy in our study, FPG 104–113mg/dl, 2hPG 131–145mg/dl would be the candidate for the criteria to diagnose diabetes, which were lower than thecurrent criteria( FPG 126mg/dl, 2hPG 200mg/dl).
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