抄録
To suppress the progression of diabetic microangiopathies, good control of blood glucose levels must be maintained. We examined the usefulness of glycosylated hemoglobin as an index of control of diabetes using the Markov process for the analysis of the prognosis of retinopathy. Two hundred and ninety-nine diabetics who were followed for over 3 years period in our clinic and whose control states were steady during the observation period were selected for this study. Grade of retinopathy was classified into 4 stages according to Scott's criteria (Stage 1 : no retinopathy, Stage 2 : Scott la and Ila, Stage 3 : Scott IIla and IIIb, Stage 4 : Scott IV and V). Glycosylated hemoglobin was measured as Hemoglobin A1 (HbA1), and patients were divied into 4 groups according to their levels of HbA1 : Group A : HbA1≤8%, Group B : 8%<HbA1≤10%, Group C : 10%<HbA1≤12% and Group D : 12%<HbA1. We estimated the transitinal probility for the course of retinopathy from Stage 1 to Stage 4. After 10 years, Group A was expected to disturbute to Stage 1 67%, Stage 2 29%, Stage 3 3% and Stage 41%, Group B to Stage 1 49%, Stage 2 45%, Stage 3 5% and Stage 4 1%, Group C to Stage 1 53%, Stage 2 30%, Stage 3 12% and Stage 4 4%, and Group D to Stage 1 24%, Stage 2 36%, Stage 3 23% and Stage 4 16% respectively (P<.001). It was concluded that HbA1 was a useful index of the control of diabetes from the viewpoint of the prognosis of diabetic retinopathy.
