TY  - JOUR
T1  - Understanding the long-term benefits and dangers of intensive therapy of diabetes: Comment on “role of intensive glucose control in development of renal end points in type 2 diabetes mellitus”
AU  - Nathan DM
Y1  - 2012/05/28
N1  - 10.1001/archinternmed.2012.438
JO  - Archives of Internal Medicine
SP  - 769
EP  - 770
VL  - 172
IS  - 10
N2  - 
The earliest clinically detectable signs of retinopathy, such as microaneurysms, do not usually occur until at least 5 years after development of T1DM. More advanced stages of retinopathy, including preproliferative retinopathy, require at least 10 years, and macular edema and proliferative retinopathy, which can lead to loss of vision, do not usually occur until 15 to 20 years of T1DM duration. Similarly, nephropathy and neuropathy usually manifest initially subclinically, with microalbuminuria and abnormal electrophysiologic findings, respectively.1 They advance over time to albuminuria and physical findings including diminished thresholds for vibration and light touch sensation. These subclinical and early clinical findings are by themselves not clinically significant; however, with time they can progress to further injury and loss of function with severe clinical consequences. The development of end-stage kidney disease requiring dialysis or a transplant usually takes 25 years or more of T1DM duration.

SN  - 0003-9926
M3  - doi: 10.1001/archinternmed.2012.438
UR  - http://dx.doi.org/10.1001/archinternmed.2012.438
ER  -