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Old 06-05-2011
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Question Which of the following facts is true about diabetes?

Which of the following statements is TRUE?
A) In the U.S. diabetic retinopathy is the leading cause of blindness in individuals >60 years.
B) Intensive glycemic control has been shown to worsen mild or moderate nonproliferative diabetic retinopathy in patients with type 1 diabetes during the first year of treatment.
C) Intensive insulin therapy in patients with type 1 diabetes cannot delay the onset and progression of retinopathy, nephropathy, and neuropathy.
D) Intensive glycemic control in patients with type 2 diabetes cannot reduce the risk of developing retinopathy, ephropathy, and neuropathy.
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Old 06-06-2011
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B) The deterioration is associated with an increased number of soft exudates (due to retinal infarcts in the superficial layers). This probably represents the closure of small retinal blood vessels that were narrowed but patent. Correction of hyperglycemia lowers the plasma volume which can put marginal vessels at risk. As noted above, increased IGF-1 levels also may contribute to the exacerbation of the retinopathy. (UpToDate)

Regarding leading causes of blindness in the US, I found the following helpful:

http://www.nei.nih.gov/eyedata/pbd1.asp
The leading cause of blindness among white persons was age-related macular degeneration (54.4% of the cases), while among black persons, cataract and glaucoma accounted for more than 60% of blindness.
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Endocrinology-, Preventive-Medicine-, Step-3-Questions, US-Healthcare-

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