Abstract
PurposeDespite progress in type 1 diabetes (T1DM) therapy, diabetic retinopathy (DR) is still a common complication. We analysed predictors and prevalence of DR in patients with T1DM lasting 10 years or more. All of the patients were considered to be currently in excellent glycemic control and treated using modern therapies.MethodsStudy included 384 (80.7% women) T1DM patients participating in the Program of Comprehensive Outpatient Specialist Care at the University Hospital in Krakow between the years 2014 and 2020. A retrospective analysis of medical records was conducted.ResultsThe patients were on average 34 ± 9.2 years old, had a BMI 25.0 ± 3.9 and a T1DM duration of 20.5 ± 7.9 years. The mean level of HbA1c throughout the follow-up (mean duration 4.9 ± 1.4 years) was 6.9 ± 1%. The group included 238 (62.0%) patients treated with insulin pumps and 99 (25.8%) on multiple daily injections, 47 (12.2%) used both methods; almost all patients were on insulin analogues. DR was confirmed in 150 (39.1%) patients, from which 109 (28.4%) were diagnosed de novo. Severe DR was occurred in just 31 cases (8.1%). In the multivariate logistic regression, independent risk factors for the presence of DR were 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 the combined presence of non-DR micro- and macrovascular chronic complications (OR 1.86; 95% CI, 1.16–3.03).ConclusionsIn this highly-selected group of T1DM patients, mostly female, the prevalence of both DR at any stage and severe DR was lower than earlier reported results from other cohorts. Independent risk factors for the DR cohort did not differ from previously reported studies.
Highlights
Diabetic retinopathy (DR) is a common chronic complication of type 1 diabetes (T1DM)
The analysed group included 238 (62%) patients treated with continuous subcutaneous insulin infusion (CSII) during the entire observation period; 99 (25.8%) were using only multiple daily injections (MDI); 47 (12.2%) used both methods during the follow-up period
We provide evidence that wellestablished independent risk factors, such as duration of diabetes, glycemic control and some others, confirmed in this very selected cohort of T1DM patients to be significant
Summary
Diabetic retinopathy (DR) is a common chronic complication of type 1 diabetes (T1DM). It remains an important cause of vision loss and preventable blindness in adults, in middle and high-income countries [1]. Other eye diseases, like glaucoma and cataracts, are more common and develop earlier in people with diabetes [3, 4]. It was recently reported, that the presence and degree of DR was an independent predictor of subclinical cardiovascular disease (CVD) [5,6,7]. A meta-analysis of 35 studies conducted world-wide in 1980–2008 estimated the overall prevalence of DR at any stage at 34.6% in a large population with a mean disease duration
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