Prevalence and predictors of developing vision-threatening diabetic retinopathy within the first three years of type 2 diabetes

Front Endocrinol (Lausanne). 2023 Dec 20:14:1305378. doi: 10.3389/fendo.2023.1305378. eCollection 2023.

Abstract

Purpose: To investigate the prevalence of diabetic retinopathy (DR) and vision-threatening DR (VTDR) in patients with type 2 diabetes mellitus (T2DM) stratified by the duration of diabetes and to identify the clinical variations and risk factors for VTDR occurring at different stages of T2DM.

Methods: This was a retrospective comparative study. Patients were divided into short- (≤3 years), intermediate- (3-7 years), and long-duration (>7 years) groups. All patients were followed-up for DR and VTDR development. Risk factors were explored using logistic regression analysis.

Results: A total of,2961 patients were included; among them, 1,036 (35.0%) patients developed DR, and 293 (9.9%) had VTDR. The frequency of VTDR in patients who developed DR in the short-duration group was significantly higher than that in the intermediate-duration group (25.7% vs. 15.0%; p = 0.019), but comparable with that of the long-duration group (25.7% vs. 31.8%; p = 0.138). Patients who developed VTDR within the first 3 years of T2DM were more likely to have a family history of diabetes (p = 0.024), had higher glycated hemoglobin (p = 0.025), were males (p = 0.042), and were notably older at the onset of diabetes (p <0.001) but younger when diagnosed with DR (p <0.001). Moreover, higher glycated hemoglobin (OR = 1.14; 95% CI: 1.00-1.29; p = 0.043) and diabetic nephropathy (DN) (OR = 2.31; 95% CI: 1.08-4.91; p = 0.030) were independent risk factors for developing VTDR during the first 3 years of T2DM.

Conclusion: The risk of DR is not high in persons with ≤3 years' duration of T2DM, however, if afflicted, the risk of VTDR should never be neglected. More frequent retinal screening is warranted in patients with newly diagnosed T2DM.

Keywords: diabetic retinopathy; early-onset retinopathy; risk factor; type 2 diabetes; vision-threatening diabetic retinopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / epidemiology
  • Diabetic Retinopathy* / etiology
  • Female
  • Glycated Hemoglobin
  • Humans
  • Male
  • Prevalence
  • Retrospective Studies

Substances

  • Glycated Hemoglobin

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Natural Science Foundation of China (Grant No. 82002891). The Shanghai Science and Technology Development Foundation (Grant No. 22QA1407500), the Shanghai Rising Stars of Medical Talent Youth Development Program (Grant No. SHWSRS [2022-65]), the Clinical Research Innovation Plan of Shanghai General Hospital (Grant No. CTCCR-2021C01), and the Natural Science Foundation of Shanghai (20ZR1445600). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.