Abstract
Little is known about the relationship between insulin resistance and proliferative diabetic retinopathy in type 1 diabetes. The aim of this article is to explore the relationship between sight-threatening proliferative diabetic retinopathy and insulin resistance. This was a cross-sectional study that included 167 type 1 diabetes patients. Insulin resistance was assessed using eGDR (estimated glucose disposal rate) formula. Diabetic retinopathy was assessed by ophthalmoscopy using Early Treatment Diabetic Retinopathy classification. The association between eGDR and proliferative diabetic retinopathy was assessed in uni- and multivariate models using stepwise logistic regression of covariates. The contribution of individual predictors in the final regresion model was examined using Wald statistic. Significantly lower eGDR's values were observed in patients with proliferative diabetic retinopathy: 5.5 vs. 7 (p = 0.002). The results remained significant (p < 0.001) after adjusting for multiple covariates (sex, diabetes duration, body mass index, HDL cholesterol, LDL cholesterol, triglycerides, smoking). eGDR variable was retained in the final model of stepwise logistic regression (p < 0.001) and showed the strongest association with proliferative diabetic retinopathy (Wald= 12.73). In type 1 diabetes patients insulin resistance was the most important independent risk factor associated with diabetic proliferative retinopathy.
Highlights
Little is known about the relationship between insulin resistance and proliferative diabetic retinopathy in type 1 diabetes
Type 1 diabetes mellitus was defined as: diabetes onset before the age of 35 years with permanent insulin treatment initiated within the first year after diagnosis
A total of 43.11% (n = 72) of patients from the targeted group were free of ocular damage; 18.57% (n = 31) had NPDR and 38.32% (n = 64) had PDR
Summary
Little is known about the relationship between insulin resistance and proliferative diabetic retinopathy in type 1 diabetes. The aim of this article is to explore the relationship between sight-threatening proliferative diabetic retinopathy and insulin resistance. With 70-100% of patients being affected, retinopathy is the most common type 1 diabetes (T1D) complication [1]. Diabetic retinopathy lesions are divided into two large categories: nonproliferative (NPDR) and proliferative (PDR). The more severe form of retinopathy, PDR, affects 15-50% of T1D patients over 15-20 years of disease duration [2, 3]. In developed countries diabetic retinopathy is the main cause of blindness in working age group [4]. Identifying patients at risk of ocular impairment is a concern for clinicians
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