 Microvascular complications included nephropathy, neuropathy, and retinopathy. Severity of nephropathy was determined based on albuminuria using four categories: normal, 0 points; microalbuminuria, 1 point; clinical albuminuria, 2 points; and dialysis, 3 points. Severity of neuropathy was categorized as normal, 0 points; chronic sensorimotor distal symmetric polyneuropathy andor cardiac autonomic neuropathy, 1 point. Severity of retinopathy was determined using four categories: normal, 0 points; simple, 1 point; pre-proliferative, 2 points; and proliferative, 3 points. Development of new, worsened, or improved microangiopathy was defined according to a change of at least one step from baseline. 