A Critique of Methods in Reported Studies of Long-term Vascular Complications in Patients with Diabetes Mellitus

@article{Kaplan1973ACO,
  title={A Critique of Methods in Reported Studies of Long-term Vascular Complications in Patients with Diabetes Mellitus},
  author={Matthew H. Kaplan and Alvan R. Feinstein},
  journal={Diabetes},
  year={1973},
  volume={22},
  pages={160 - 174}
}
From 149 papers that referred to the development of vascular complications in patients with diabetes mellitus, we selected thirty-three that could be used for analysis of methodology. Eight of these reports contained inception cohorts in which a valid statistical risk could be calculated from the target events (cited in the numerators) and the initial states (cited in the denominators). Twenty-five reports contained longitudinal prevalence groups that were suitable only for appraisal of the… Expand
The importance of classifying initial co-morbidity in evaluating the outcome of diabetes mellitus.
TLDR
Among 5-yr survivors, the occurrence rate of new vascular events (or ‘diabetic complications’) was directly related to the same features of age and co-morbidity that seemed to affect fatality. Expand
Hyperlipidemia and the control of diabetes mellitus.
  • A. Drash
  • Medicine
  • American journal of diseases of children
  • 1976
TLDR
There is a long-standing controversy between diabetologists as to whether the level of metabolic control of diabetes mellitus affects the long-term outcome, and several studies have appeared that significantly increase the scientific basis for this position, while remaining inconclusive in a practical, therapeutic sense. Expand
The changing natural history of nephropathy in type I diabetes.
TLDR
The development of diabetic nephropathy consists of at least two stages: the onset of proteinuria, although related to the level of exposure to hyperglycemia, appears to be influenced by genetic and/or environmental factors, and the second stage, progression to renal failure, seems to been influenced by processes related to maturation or aging. Expand
A simulation model of the cost of the incidence of IDDM in Spain
TLDR
A discrete event simulation model was developed to approximate the natural history of a cohort of newly diagnosed patients in a given year and used to calculate the average costs which would accumulate during the lifetime of the group of patients. Expand
complications of Diabetes Mellitus: Relationship to Metabolic Dysfunction
TLDR
Current available evidence favors the thesis that the complications are secondary to the metabolic disorder and thus should be prevented or significantly reduced or delayed by achieving a high degree of metabolic control of diabetes mellitus. Expand
Can adequate control of diabetes prevent the development of vascular complications? A mini review.
TLDR
It remains to establish whether continuous optimal control by insulin treatment generally can prevent early although clinical microangiopathy, and the development of instruments and other aids for improved metabolic control, such as transplantation of insulin-producing tissue, would seem to be a logical step in this direction. Expand
Incidence of Diabetic Retinopathy and Blindness: A Population-based Study in Rochester, Minnesota
TLDR
Among the 1135 Rochester residents discovered to have diabetes in the period 1945–69, the prevalence of retinopathy was 2.6% at the time of initial diagnosis and the subsequent incidence was 17.4 per 1000 person-years, and the epidemiologic patterns for proliferative Retinopathy were qualitatively similar to those for nonproliferativeretinopathy. Expand
Relation of diabetic control to development of microvascular complications
TLDR
The opinion of the author is that strict control of diabetes is worthwile in patients with long life expectancy and no psychological, social or cultural handicaps. Expand
The Memphis and Atlanta Continuing Care Programs for Diabetes. II. Comparative Analyses of Demographic Characteristics, Treatment Methods, and Outcomes over a 9–10-year Follow-up Period
TLDR
Standardized mortality ratios (SMR) revealed by SMR appeared to relate to perceived severity of diabetes in each cohort and clinical assessment of effectiveness of each mode of therapy. Expand
Control of the Blood Glucose in Diabetes Mellitus: Is it Valuable? Is it Feasible?
SummaryThe controversy over whether strict blood glucose control prevents or attenuates the complications of diabetes is still unresolved, but the available data support the value of good bloodExpand
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TLDR
It must be obvious that any assessment of the successful management or "control" of patients of long duration can only be related to intermittent observations of the level of blood sugar or glycosuria, and it is questionable whether such evidence can ever be sufficiently accurate to support the dogmatic conclusions which have been made. Expand
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