LAUSR

We are thankful for the response from Camoin et al. (1) to our article (2) showing the association of severe diabetic retinopathy (SDR) with cardiovascular disease, including peripheral artery disease, in long-standing type 1 diabetes. Importantly, the association was present even in the absence of DKD, a well-established risk factor for cardiovascular events and premature mortality (3). Results from the French cohort of patients with type 1 diabetes further strengthen the importance of SDR as a risk factor for lower-extremity ischemia, foot ulcers, and amputations. In their cohort ( n = 204) they were able to show an association between SDR and foot ulcers after adjustment for the presence of DKD and other cardiovascular risk factors, even with shorter diabetes duration (21 ± 13 years) and …