Incidence of self reported glaucoma in people with diabetes mellitus
Department of Ophthalmology and Visual Sciences,
University of Wisconsin Medical School, Madison, USA
Correspondence to: Barbara E K Klein, MD, MPH, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, 610 North Walnut Street, 460 WARF, Madison, WI 53705-2397, USA.
Accepted for publication 14 May 1997
AIM
To determine the incidence of self reported
glaucoma in a group of people with diabetes mellitus.
METHODSIn an 11 county area in southern
Wisconsin, a cohort of people with diabetes mellitus was identified and
characterised by history, physical examination, fundus photographs, and
laboratory evaluation in 1980-2 (n=2366). The cohort was followed for
10 years with 891 younger onset and 987 older onset people
participating in at least one follow up examination.
RESULTSThe 10 year incidence of glaucoma was
3.7% in younger onset people, 6.9% in older onset people not using
insulin, and 11.8% in older onset people using insulin. Univariate
analyses revealed that in younger onset people greater body mass index,
older age, longer duration of diabetes, history of cataract surgery,
and increased severity of diabetic retinopathy at baseline conferred increased risk. In older onset people using insulin, older age and
longer duration of diabetes, higher intraocular pressure, and history
of cataract surgery at baseline were associated with increased risk of
glaucoma. In multivariate analyses, only age was significantly related
to increased incidence in younger onset people and age, intraocular
pressure, and insulin use were significantly associated with increased
risk in the older onset group.
CONCLUSIONMost risk factors associated with self
reported glaucoma in people with diabetes cannot currently be modified
to decrease incidence. Older onset people who are at increased risk of
many ocular complications of diabetes may be particularly in need of specialised ophthalmic observation.
© 1997 by British Journal of Ophthalmology
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