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Trends in diabetic eye disorders and associated comorbidities in Taiwan: a 10-year nationwide population-based cohort study
  1. Chia-Chen Lin1,
  2. Chia-Yi Lee2,
  3. Jing-Yang Huang3,
  4. Sheng-Min Hsu1,
  5. Jia-Horung Hung1,4,
  6. Shun-Fa Yang3,5
  1. 1Department of Ophthalmology, National Cheng Kung University Hospital, Tainan, Taiwan
  2. 2Nobel Eye Institute, Taipei, Taiwan
  3. 3Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
  4. 4Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  5. 5Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
  1. Correspondence to Dr Jia-Horung Hung, Department of Ophthalmology, National Cheng Kung University, Tainan, Taiwan; hungjh{at}mail.ncku.edu.tw; Professor Shun-Fa Yang, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; ysf{at}csmu.edu.tw

Abstract

Background/aims In-depth analysis is needed to investigate trends in diabetic retinopathy (DR), diabetic macular oedema (DME) and associated comorbidities in patients with type 2 diabetes mellitus (T2DM) so that we can better understand their prevalence and incidence.

Methods A retrospective population-based study was conducted using data from Taiwan’s National Health Insurance Research Database from 2005 to 2015, and T2DM, DR and associated comorbidities were identified based on diagnostic codes. We used a standardised incidence rate with age and sex adjustment to estimate the prevalence and incidence of DR, proliferative DR (PDR), advanced PDR (aPDR) and DME, while the difference in each study period was calculated as the annual percentage change. We used the absolute standardised difference to analyse changes in related comorbidities in different periods.

Results The population of patients with DM increased over 50% between 2005 and 2015, while the prevalence and incidence of DR decreased, as did the incidence of PDR and aPDR. However, the prevalence and incidence of DME increased over the course of 10 years, with an upward trend in all forms of DR. The percentage of patients with hyperlipidaemia in DME and all DR increased, and the percentage of patients with end-stage renal disease (ESRD) was also elevated in DME.

Conclusion The prevalence and incidence of DR, PDR and aPDR decreased with time in patientsT2DM, while the ratio of DME increased gradually. The incidence of hyperlipidaemia also increased in all forms of diabetic eye disorders, while ESRD increased solely in DME.

  • Epidemiology
  • Public health
  • Retina

Data availability statement

Data are available on reasonable request. Data are not publicly available. Details about the statistical analysis plan used in this paper can be obtained from the corresponding authors on reasonable request.

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Data availability statement

Data are available on reasonable request. Data are not publicly available. Details about the statistical analysis plan used in this paper can be obtained from the corresponding authors on reasonable request.

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Footnotes

  • Contributors J-HH and S-FY designed the study. C-CL, C-YL and J-HH prepared the manuscript. All authors (C-CL, C-YL, J-YH, S-MH, J-HH and S-FY) collected the clinical data. J-YH, J-HH and S-FY carried out the statistical analysis and analysed the data. J-HH supervised the research. All authors (C-CL, C-YL, J-YH, S-MH, J-HH and S-FY) reviewed and revised the manuscript. Both J-HH and S-FY are the guarantors.

  • Funding This study was financially supported by funding from National Cheng Kung University Hospital, Taiwan (NCKUH-11102004), and the Ministry of Science and Technology (MOST 110-2314-B-006-086-MY3); these grants were awarded to J-HH.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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