This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (164)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Ronald Klein, MD, MPH; Scot E. Moss, MA; Barbara E. K. Klein, MD, MPH; David L. DeMets, PhD

Arch Intern Med. 1989;149(2):266-272.

Abstract
• The relationship of survival to systemic and ocular factors in diabetic persons was studied using data collected as part of the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Six years after the baseline examination, 9.5% of 996 insulintaking people who were younger than age 30 years when their diabetes was diagnosed (younger onset) had died. Of 1370 people whose diabetes was diagnosed after age 30 years (older onset), 35.3% had died. After adjusting for age and sex, longer duration of diabetes, presence of proteinuria, a history of cardiovascular disease, higher blood pressure, diuretic use, a history of smoking, poorer visual acuity, and more severe retinopathy were significantly associated with decreased survival in both groups. Glaucoma was associated with decreased survival in the younger onset group and cataract in the older onset group. These findings suggest that some ocular complications are important risk indicators for death. Their presence in diabetic patients suggests the need for frequent examinations to detect systemic complications and to intervene to minimize their effect.

(Arch Intern Med 1989;149:266-272)

Author Affiliations
From the Department of Ophthalmology (Drs R. Klein and B. Klein and Mr Moss) and the Biostatistics Center (Dr DeMets), University of Wisconsin Medical School, Madison.

Footnotes
Accepted for publication Aug 13, 1988.

Reprint requests to Department of Ophthalmology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (Dr R. Klein).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Mortality associated with cataract surgery
Dorairaj et al.
Br J Ophthalmol 2009;93:277-278.
FULL TEXT  

Reduced mortality compared with national averages following phacoemulsification cataract surgery: a retrospective observational study
Blundell et al.
Br J Ophthalmol 2009;93:290-295.
ABSTRACT | FULL TEXT  

Eye Care in the United States: Do We Deliver to High-Risk People Who Can Benefit Most From It?
Zhang et al.
Arch Ophthalmol 2007;125:411-418.
ABSTRACT | FULL TEXT  

Retinopathy Predicts Cardiovascular Mortality in Type 2 Diabetic Men and Women
Juutilainen et al.
Diabetes Care 2007;30:292-299.
ABSTRACT | FULL TEXT  

The beneficial effect of coronary-artery-bypass surgery on survival in patients with diabetic retinopathy
Ohno et al.
Eur. J. Cardiothorac. Surg. 2006;30:881-886.
ABSTRACT | FULL TEXT  

Impact of Diabetic Retinopathy on Cardiac Outcome After Coronary Artery Bypass Graft Surgery: Prospective Observational Study
Ono et al.
Ann. Thorac. Surg. 2006;81:608-612.
ABSTRACT | FULL TEXT  

Age-related eye disease, visual impairment, and survival: the beaver dam eye study.
Knudtson et al.
Arch Ophthalmol 2006;124:243-249.
ABSTRACT | FULL TEXT  

Concurrent Visual and Hearing Impairment and Risk of Mortality: The National Health Interview Survey
Lam et al.
Arch Ophthalmol 2006;124:95-101.
ABSTRACT | FULL TEXT  

Diabetic Retinopathy Is Associated With Mortality and Cardiovascular Disease Incidence: The EURODIAB Prospective Complications Study
van Hecke et al.
Diabetes Care 2005;28:1383-1389.
ABSTRACT | FULL TEXT  

Cost-Effectiveness Analysis of Telemedicine to Evaluate Diabetic Retinopathy in a Prison Population
Aoki et al.
Diabetes Care 2004;27:1095-1101.
ABSTRACT | FULL TEXT  

Associations of Mortality With Ocular Disorders and an Intervention of High-Dose Antioxidants and Zinc in the Age-Related Eye Disease Study: AREDS Report No. 13
AREDS Research Group
Arch Ophthalmol 2004;122:716-726.
ABSTRACT | FULL TEXT  

Smoking and Progression of Diabetic Nephropathy in Type 1 Diabetes
Hovind et al.
Diabetes Care 2003;26:911-916.
ABSTRACT | FULL TEXT  

Visual Acuity Impairment and Mortality in US Adults
Lee et al.
Arch Ophthalmol 2002;120:1544-1550.
ABSTRACT | FULL TEXT  

Encapsulated Cell-Based Delivery of CNTF Reduces Photoreceptor Degeneration in Animal Models of Retinitis Pigmentosa
Tao et al.
IOVS 2002;43:3292-3298.
ABSTRACT | FULL TEXT  

Retinal microvascular abnormalities and blood pressure in older people: the Cardiovascular Health Study
Wong et al.
Br J Ophthalmol 2002;86:1007-1013.
ABSTRACT | FULL TEXT  

Baseline Cataract Type and 10-Year Mortality in the Italian-American Case-Control Study of Age-related Cataract
Williams et al.
Am J Epidemiol 2002;156:127-131.
ABSTRACT | FULL TEXT  

Natural history and prognostic factors of diabetic nephropathy in type 2 diabetes
Jude et al.
QJM 2002;95:371-377.
ABSTRACT | FULL TEXT  

The Treatment of Hypertension in Adult Patients With Diabetes
Arauz-Pacheco et al.
Diabetes Care 2002;25:134-147.
FULL TEXT  

Smoking and Mortality Among Women With Type 2 Diabetes: The Nurses' Health Study cohort
Al-Delaimy et al.
Diabetes Care 2001;24:2043-2048.
ABSTRACT | FULL TEXT  

Prospective Study of Cataract Extraction and Risk of Coronary Heart Disease in Women
Hu et al.
Am J Epidemiol 2001;153:875-881.
ABSTRACT | FULL TEXT  

Baseline Characteristics of the Diabetic Participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Barzilay et al.
Diabetes Care 2001;24:654-658.
ABSTRACT | FULL TEXT  

The Risk of Cardiovascular Disease Mortality Associated With Microalbuminuria and Gross Proteinuria in Persons With Older-Onset Diabetes Mellitus
Valmadrid et al.
Arch Intern Med 2000;160:1093-1100.
ABSTRACT | FULL TEXT  

Mixed Lens Opacities and Subsequent Mortality
West et al.
Arch Ophthalmol 2000;118:393-397.
ABSTRACT | FULL TEXT  

Cost-Utility Analysis of Screening Intervals for Diabetic Retinopathy in Patients With Type 2 Diabetes Mellitus
Vijan et al.
JAMA 2000;283:889-896.
ABSTRACT | FULL TEXT  

Diabetic Retinopathy in African Americans With Type 1 Diabetes: The New Jersey 725: II. Risk Factors
Roy
Arch Ophthalmol 2000;118:105-119.
ABSTRACT | FULL TEXT  

Association of Ocular Disease and Mortality in a Diabetic Population
Klein et al.
Arch Ophthalmol 1999;117:1487-1495.
ABSTRACT | FULL TEXT  

Effect of Diuretic-Based Antihypertensive Treatment on Cardiovascular Disease Risk in Older Diabetic Patients With Isolated Systolic Hypertension
Curb et al.
JAMA 1996;276:1886-1892.
ABSTRACT  

Discrete Event Simulation to Evaluate Screening for Diabetic Eye Disease
Davies and Canning
SIMULATION 1996;66:209-216.
ABSTRACT  

The Incidence of Hypertension in Insulin-Dependent Diabetes
Klein et al.
Arch Intern Med 1996;156:622-627.
ABSTRACT  

Cost-Effectiveness of Detecting and Treating Diabetic Retinopathy
Javitt and Aiello
ANN INTERN MED 1996;124:164-169.
ABSTRACT | FULL TEXT  

Age-Related Eye Disease and Survival: The Beaver Dam Eye Study
Klein et al.
Arch Ophthalmol 1995;113:333-339.
ABSTRACT  

Pharmacy Update: Drug/Drug and Drug/Disease Interactions and Diabetes
White and Campbell
The Diabetes Educator 1995;21:283-289.
 

The Association of Glycemia and Cause-Specific Mortality in a Diabetic Population
Moss et al.
Arch Intern Med 1994;154:2473-2479.
ABSTRACT  

Relationship of Hyperglycemia to the Long-term Incidence and Progression of Diabetic Retinopathy
Klein et al.
Arch Intern Med 1994;154:2169-2178.
ABSTRACT  

Cataract and Survival in an Elderly Nondiabetic Population
Thompson et al.
Arch Ophthalmol 1993;111:675-679.
ABSTRACT  

Excess Mortality Associated With Diuretic Therapy in Diabetes Mellitus
Parving
Arch Intern Med 1992;152:1093-1094.
ABSTRACT  

The Prevalence and Incidence of Lower Extremity Amputation in a Diabetic Population
Moss et al.
Arch Intern Med 1992;152:610-616.
ABSTRACT  

Microalbuminuria in a Population-Based Study of Diabetes
Klein et al.
Arch Intern Med 1992;152:153-158.
ABSTRACT  

Two Dilemmas of Diabetes
Kaplan
Arch Intern Med 1991;151:1270-1272.
ABSTRACT  

The Incidence of Gross Proteinuria in People With Insulin-Dependent Diabetes Mellitus
Klein et al.
Arch Intern Med 1991;151:1344-1348.
ABSTRACT  

Excess Mortality Associated With Diuretic Therapy in Diabetes Mellitus
Warram et al.
Arch Intern Med 1991;151:1350-1356.
ABSTRACT  

Is Blood Pressure a Predictor of the Incidence or Progression of Diabetic Retinopathy?
Klein et al.
Arch Intern Med 1989;149:2427-2432.
ABSTRACT