Affiliation:
1. Department of Ophthalmology, University of Wisconsin Medical School Madison, Wisconsin
Abstract
Objective
To determine whether cigarette smoking is associated with the incidence and progression of diabetic retinopathy.
Research Design and Methods
Younger-onset diabetic subjects who had been diagnosed at >30 yr of age and taking insulin (n = 1210) and a random sample of older-onset diabetic subjects diagnosed at ≥30 yr of age (n = 1780) were selected. Baseline examinations were conducted on 996 youngerand 1370 older-onset subjects. Incidence of retinopathy was based on 138 younger-onset and 154 older-onset insulin-taking subjects and 321 older-onset non-insulintaking subjects who were free of retinopathy at baseline. Progression of retinopathy was based on 530 youngeronset and 418 older-onset insulin-taking subjects and 486 older-onset non-insulin-taking subjects with less than proliferative diabetic retinopathy at baseline.
Results
Baseline smoking history was categorized by status (nonsmoker, ex-smoker, current smoker) and pack-years smoked while diabetic. Retinopathy was documented by stereoscopic fundus photography. In univariate analyses, the only significant association was between pack-years and progression to proliferative diabetic retinopathy in older-onset insulin-taking subjects (P < 0.01). After controlling for known risk factors for the incidence and progression of retinopathy, pack-years smoked was borderline significant (P = 0.052) in predicting incidence of retinopathy in youngeronset subjects. Smoking was not associated with incidence in older-onset subjects or with progression or progression to proliferative diabetic retinopathy in any of the groups.
Conclusions
Smoking is not likely to be an important risk factor for diabetic retinopathy.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
73 articles.
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