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Clinical science
Differences in incidence of diabetic retinopathy between type 1 and 2 diabetes mellitus: a nine-year follow-up study
  1. Pedro Romero-Aroca1,2,
  2. Raul Navarro-Gil1,2,
  3. Aida Valls-Mateu3,
  4. Ramon Sagarra-Alamo4,
  5. Antonio Moreno-Ribas3,
  6. Nuria Soler1,2
  1. 1Ophthalmology Service, University Hospital Sant Joan, Reus, Spain
  2. 2Institut de Investigacio Sanitaria Pere Virgili (IISPV), Universitat Rovira and Virgili, Reus, Spain
  3. 3Department of Computer Engineering and Mathematics, Universitat Rovira and Virgili, Reus, Spain
  4. 4Health Care Area Reus-Priorat, Institut Catala de la Salut (ICS), Institut de Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira and Virgili, Reus, Spain
  1. Correspondence to Dr Pedro Romero-Aroca Hospital Universtario Sant Joan, Avenida, Doctor, Josep Laporte 2, Reus 43204, Spain; romeropere{at}gmail.com, promero{at}grupsagessa.com

Abstract

Background/aims To determine the incidence of any diabetic retinopathy (any-DR), sight-threatening diabetic retinopathy (STDR) and diabetic macular oedema (DMO) and their risk factors in type 1 diabetes mellitus (T1DM) over a screening programme.

Methods Nine-year follow-up, prospective population-based study of 366 patients with T1DM and 15 030 with T2DM. Epidemiological risk factors were as follows: current age, age at DM diagnosis, sex, type of DM, duration of DM, arterial hypertension, levels of glycosylated haemoglobin (HbA1c), triglycerides, cholesterol fractions, serum creatinine, estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (UACR).

Results Sum incidence of any-DR was 47.26% with annual incidence 15.16±2.19% in T1DM, and 26.49% with annual incidence 8.13% in T2DM. Sum incidence of STDR was 18.03% with annual incidence 5.77±1.21% in T1DM, and 7.59% with annual incidence 2.64±0.15% in T2DM. Sum incidence of DMO was 8.46% with annual incidence 2.68±038% in patients with T1DM and 6.36% with annual incidence 2.19±0.18% in T2DM. Cox's survival analysis showed that current age and age at diagnosis were risk factors at p<0.001, as high HbA1c levels at p<0.001, LDL cholesterol was significant at p<0.001, eGFR was significant at p<0.001 and UACR at p=0.017.

Conclusions The incidence of any-DR and STDR was higher in patients with T1DM than those with T2DM. Also, the 47.26% sum incidence of any-DR in patients with T1DM was higher than in a previous study (35.9%), which can be linked to poor metabolic control of DM. Our results suggest that physicians should be encouraged to pay greater attention to treatment protocols for T1DM in patients.

  • Retina
  • Telemedicine
  • Epidemiology

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bjophthalmol-2016-310063

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    Footnotes

    • Contributors PRA: contributed to study conception and design, collected research data, reviewed the statistical analysis, wrote the discussion and edited the manuscript, contributing to the final approval of the version sent for publication. RN-G: contributed to study conception and design, contributed to ophthalmological data collection, diagnosed diabetic macular oedema, carried out the laboratory procedures, wrote the discussion and made a critical review, contributing to the final approval of the version sent for publication. AV-M: contributed to study design and the statistical analysis, interpreted the research data, made a critical review and reviewed the translation, contributing to the final approval of the version sent for publication. RS-A: contributed to study conception and design, contributed to diabetes mellitus data collection, carried out the retinographies, interpreted the research data and helped to write the manuscript, contributing to the final approval of the version sent for publication. AM-R: contributed to study design and the statistical analysis, interpreted research data and contributed to the interpretation of the study findings, contributing to the final approval of the version sent for publication. NS: contributed to ophthalmological data collection, carried out retinographies and OCT procedures and interpreted the research data, contributing to the final approval of the version sent for publication.

    • Funding This study was funded by research projects FI12/01535 June 2013 and FI15/01150 July 2015 (Instituto de Investigaciones Carlos III (IISCIII) of Spain), and FEDER funds.

    • Competing interests None declared.

    • Ethics approval Hospital Universitario Sant Joan de Reus Ethics Committee [approval no. 13-01-31/proj6].

    • Provenance and peer review Not commissioned; externally peer reviewed.