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Abstract
Aims This study aims to investigate the associations between commonly used systemic medications and diabetic retinopathy (DR).
Methods Individuals with linked primary care prescription data from the UK Biobank were included. Cases were defined as individuals with a Hospital Episode Statistics-coded or primary care recorded diagnosis of DR or self-reported DR. Controls were matched for age, sex, glycosylated haemoglobin, duration of diabetes mellitus (DM), hypertension status and cardiovascular disease status. ORs and 95% CIs were calculated using conditional univariate and multivariable logistic regression models.
Results A total of 3377 case subjects with DR were included in the study and matched with 3377 control subjects. In multivariable logistic regression, increased odds of incident DR were observed for exposure to short-acting insulins (OR 1.63; 95% CI 1.22 to 2.18), medium-acting insulins (OR 2.10; 95% CI 1.60 to 2.75), sulfonylureas (OR 1.30; 95% CI 1.16 to 1.46). Instead, the use of fibrates (OR 0.71; 95% CI 0.53 to 0.94) and Cox-2 inhibitors (OR 0.68; 95% CI 0.58 to 0.79) was associated with decreased odds of incident DR. Dose–response relationships were observed for all five drug categories (all p<0.05).
Conclusions This study comprehensively investigated the associations between systemic medication use and DR and found significant associations between the use of short-acting insulins, medium-acting insulins and sulfonylureas with increased odds of incident DR. In contrast, fibrates and Cox-2 inhibitors were associated with decreased odds of incident DR. These findings may provide valuable insights into DM medication management and serve as a reference for the prevention of DR in patients with DM.
- Drugs
- Pharmacology
- Retina
Data availability statement
Data are available in a public, open access repository. This present study was conducted under application number 87083 of the UK Biobank resource. Data can be accessed through applications on UK Biobank website (https://www.ukbiobank.ac.uk/).
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Data availability statement
Data are available in a public, open access repository. This present study was conducted under application number 87083 of the UK Biobank resource. Data can be accessed through applications on UK Biobank website (https://www.ukbiobank.ac.uk/).
Footnotes
GJ and YM are joint first authors.
Contributors YW and ZL had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. ZL is guarantor. GJ, YM, YW and ZL led the conception and design of the study. GJ and YM contributed to the data analyses, data interpretation and wrote the draft of the manuscript.
Funding This study was supported by the Guangzhou Basic Research Program, City & University (Institute) Joint Funding Project (2023A03J0174, SL2023A03J00514), National Natural Science Foundation of China of Guangdong Province (2022A1515011181, 2021A1515011673) and National Natural Science Foundation of China (81900841, 81873673).
Disclaimer The funding organisation played no role in the design or execution of this research.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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