INCIDENCE AND RISK FACTORS OF DIABETIC RETINOPATHY AMONG PATIENTS WITH TYPE 2 DIABETES IN A COMMUNITY HOSPITAL, CENTRAL THAILAND

Abstract

Background: Diabetic retinopathy (DR) is one of the ocular complications among patients with type 2 diabetes (T2D) in both developed and developing countries. At present, epidemiological data of DR and the risk factors among patients with T2D especially in Thai community hospitals have been limited.
 Methods: A retrospective cohort study was conducted between January 1, 2013 and December 31, 2020 to determine the incidence and risk factors of DR among patients with T2D visiting Tha Wung Hospital, Lop Buri Province, central Thailand. DR was determined according to the International Classification of Diseases, Tenth Revision codes in E113 presented in medical records. Multivariate Cox regression analysis was performed to obtain the adjusted hazard ratios (HR) and 95% confidence interval (CI) of the factors related to DR.
 Results: A total of 2007 patients with T2D were enrolled in the present study. During the study period, participants (5.3%) had a diagnosis of DR; the incidence rate was 0.9 per 100 person-years (95% CI; 0.7-1.1). The independent risk factors for DR included HbA1c ≥8% (adjusted hazard ratio (AHR) = 4.7, 95% CI; 2.5-8.7), urine albumin 3+ (AHR = 2.4, 95% CI; 1.1-5.3), urine albumin 4+ (AHR = 20.3, 95% CI; 2.7-150.9), and a longer distance between residential area (AHR= 1.3, 95% CI; 1.2-1.4).
 Conclusion: Patients with T2D should be encouraged to reach their glycemic control indicated by HbA1c level. Additionally, effective health interventions should be conducted to contribute appropriate access to diabetic care for patients residing in remote areas.