Classification of Diabetic Complications from the Combination of Neuropathy, Retinopathy and Proteinuria

Abstract

Diabetic neuropathy, retinopathy and nephropathy are representative diabetic complications. Even so, while one diabetic patient may display none of these complications, another may have them all since the pattern of diabetic complications in patients is so varied. This report concerns the classification of diabetic complications from the combination of neuropathy, retinopathy and nephropathy in 1191 diabetic patients who visited our diabetes center during the 12-month period from January through December, 1976. The classification of complications and their distribution were as follows: Type I (no complications), 17.8%; Type II (neuropathy only), 16.4%; Type III (neuropathy and retinopathy), 18.5%; Type IV (neuropathy, retinopathy and proteinuria), 15.7 %; Type V (proteinuria only), 9.5%; Type VI (neuropathy and proteinuria), 8.1%; Type VII (retinopathy only), 10.0%; and Type VIII (retinopathy and proteinuria), 4.0%. Diagnosis of neuropathy was based on diabetes-caused sensory disturbances or on diminished or lost knee jerk or Achilles jerk. Diagnosis of retinopathy was based on Ia and more advanced findings for Scott's classification. Diagnosis of nephropathy was based on proteinuria at examinaton. In patients with a short duration of diabetes, Types I and II were common, whereas in patients with a long duration of diabetes, Types III and IV were increased. No significant relationships were apparent between sex, age at examination, fasting blood sugar level at first visit, and classification of diabetic complications. On the other hand, the frequency of hypertension was higher in Types IV and VIII than in the other types. © 1979, THE JAPAN DIABETES SOCIETY. All rights reserved.