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L. Kessel, M. Larsen, INTER99 Study Group; Lens Fluorescence in Newly Diagnosed Type 2 Diabetic Patients . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3471.
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Purpose: Lens autofluorescence increases proportionally with life-time glycemia. The aim of the present study was to examine lens autofluorescence in asymptomatic newly diagnosed type 2 diabetes patients found by population screening in order to assess prediagnostic glycemic load. Methods: Subjects aged 30-60 years were recruited from a population-based study (the Inter99 study). 141 subjects who were diagnosed with type 2 diabetes in course of the study as a result of an oral glucose tolerance test and 412 normo-glycemic control subjects were included. Results: Lens autofluorescence was significantly higher in the group of newly diagnosed type 2 diabetic subjects (p=0.004, after correction for the effect of age by multiple regression analysis) than in non-diabetic subjects, but the majority of diabetic subjects (95.7%) had fluorescence values within the normal range. Twenty-nine of the diabetic subjects had been checked for diabetes by blood glucose measurement within the last 2 years prior to the study with a negative result. Lens fluorescence values in the rest of the diabetic subjects were not different from the latter group (p=0.78), indicating that the average duration of hyperglycemia in all newly diagnosed diabetic subjects was limited to a few years, probably 2 years or less, before the examination. Conclusions: Population screening for type 2 diabetes mellitus results in earlier diagnosis of the condition than routine clinical practice where diabetes is diagnosed when it has become symptomatic or as an incidental finding. The present study indicates that type 2 diabetes is detected very early, probably within 2 years, after biochemical onset of the disease by population screening. This is likely to result in a significant improvement in outcome for the majority of patients.
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