436-P: Low Prevalence of Diabetic Retinopathy in Type 1 Diabetes Patients with a Long-Term Modernly Treated Disease and Very Good Glycaemic Control: A Retrospective Single-Center Analysis

Abstract

Despite continuous progress in the therapy of type 1 diabetes (T1DM), diabetic retinopathy (DR) is still a common chronic complication. We aimed to analyse DR prevalence and its predictors in patients with T1DM lasting 10 years or more, treated with modern methods, and with excellent glycaemic control. The analysis included data from 384 (80.7% women) patients taking part in the Polish National Health Fund’s Program of Comprehensive Outpatient Specialist Care at the University Hospital in Krakow between 2014-2020. A retrospective analysis of data from medical records was applied. T1DM patients of average 34 ± 9.2 years, mean BMI of 25.0 ± 3.9 and diabetes duration of 20.5 ± 7.9 years was included. The mean HbA1c of all patients throughout the follow-up period was 6.9 ± 1 % [52 mmol/l]. The analysed group consisted of 238 (62,0%) patients treated with CSII, 99 (25.8%) treated with MDI; and 47 (12.2%) who used both methods during the observation period. All patients used short-acting analogues, 144 (98.6%) MDI users were treated with long-acting analogues. DR was confirmed in 150 (39.1%) patients, 109 (72.2 %) of them were diagnosed de novo in the analysed period. Severe DR, defined as an advanced non-proliferative DR or proliferative DR, was observed in 31 persons (8.07% of the entire study group and 20.7% of the DR group).In the multivariate logistic regression model, T1DM duration (OR 1.13; 95% CI, 1.09-1.19), HbA1c level (OR 1.41; 95% CI, 1.08-1.84), LDL level (OR 1.79; 95% CI, 1.16-2.87), and combined incidence of non-DR micro- and macrovascular chronic complications (OR 1.86; 95% CI, 1.16-3.03) were independent risk factors for DR presence. In our long-term retrospective study, the prevalences of both any stage of DR and severe DR were lower than reported in other cohorts from earlier periods. Independent risk factors for DR in this highly selected cohort did not differ from the previously reported. Disclosure P. Surowiec: None. B. Matejko: Other Relationship; Self; Ascensia Diabetes Care, Roche Diabetes Care. M. Kopka: None. A. Filemonowicz-skoczek: None. T. Klupa: Advisory Panel; Self; Dexcom, Inc., Ypsomed Group, Employee; Spouse/Partner; Ascensia Diabetes Care, Research Support; Self; Abbott Diabetes, Speaker’s Bureau; Self; Bioton S. A., Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk Inc., Sanofi-Aventis. B. A. Romanowska-dixon: None. K. Cyganek: Advisory Panel; Self; Medtronic, Speaker’s Bureau; Self; Lilly Diabetes, Novo Nordisk. M. Malecki: Advisory Panel; Self; Abbott Diabetes, Medtronic, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Merck & Co., Inc., Mundipharma International, Novo Nordisk, Sanofi-Aventis, Servier Laboratories.