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The EURODIAB IDDM Complications Study
Group have now secured funding to follow-up the
original participants of the EURODIAB study.
A cross sectional survey of 3250 people with IDDM
in 29 centres in Europe was funded by the EC in
1989-91. In that study, we demonstrated several
unique findings. We showed that the relationship
between blood pressure and albumin excretion rate
differed strikingly between patients with and without
retinopathy. In patients without retinopathy, mean
AER was normal even when blood pressure was high.
We also showed that the prevalence of microalbuminuria
was not rare, as commonly supposed, in people who
had had IDDM for less than 5 years. For the first
time, we demonstrated a clear and consistent adverse
effect of smoking on microvascular complications,
and also showed that educational status was predictive
of diabetes complications. More controversially,
we suggested that pregnancy may have a protective
effect on microvascular complications in the mother.
We will now explore these and other findings in
a re-examination of the original cohort, 5-6 years
after the baseline examinations. Centres will ascertain
the vital status of their participants, and ascertain
the cause of death in those who have died. The
survivors will be invited to complete a questionnaire
on medical events since the original study, lifestyle
factors, medication, socioeconomic status, nutrition,
pregnancies, the impact of diabetes on their lives,
and knowledge about diabetes. They will also undergo
a clinical examination, which will include a blood
pressure measurement, resting ECG, height, weight
and body fat measurements, retinal photography,
a neurological examination, a urine collection
for estimation of albuminuria, and blood tests
for glycated haemoglobin.
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A
centralised information system (CIS) will be
designed and implemented by the co- ordinating
centre. We will assist all centres in gaining
access to the Internet, so that they can readily
communicate with us and each other. The CIS
will be used for direct data transfer to the
co-ordinating centre from the local centres
and from the laboratories, and will act as
a repository for the final dataset. Local centres,
either individually or in groups, will access
the dataset locally, and perform their own
analyses. Support and training will be provided
from the co-ordinating centre. The CIS will
also be used to communicate with centres about
data queries and study progress, and will also
be used as a repository of draft and completed
papers by the group and for the template of
presentation materials, such as overheads and
slides.
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