The aim of the study was to identify factors associated with nonattendance in a Danish nationwide screening program for diabetic retinopathy among people with type 2 diabetes. RESEARCH DESIGN AND METHODSA retrospective observational study linking individual-level register data was performed. First, we compared characteristics of 156,878 people with type 2 diabetes divided into attenders and never-attenders on the basis of their screening history over a 6-year period. Second, we assessed 230,173 screening intervals within the same 6year period. Mixed-effects models were used to investigate the effect of sociodemographic and health-related factors on the likelihood of having a nonattender interval (i.e., failing to attend screening within the recommended interval).

Inflammation is considered a contributing factor to obesity-linked insulin resistance, hyperglycemia and hyperlipidemia leading to type 2 diabetes (T2D). Cytokines are increased in early T2D reflecting a phenotypic switch of the circulating immune cells. To identify cellular inflammatory markers to identify patients at risk to develop T2D, blood from subjects with normal and impaired glucose tolerance was analyzed by flow cytometry. The markers were correlated with known risk factors for T2D (FPG, 2 h PG, HbA1c and BMI). By random forest analysis for each metabolic risk factor the four highest ranked immune cell markers was identified. Foremost, the results showed a reduction of subpopulations of TLR4 expressing T and B cells and T cells expressing the IL-21 receptor with increasing BMI. These data demonstrate that circulating immune cells displayed an altered phenotype already in patients having increase of common diabetic risk factors. These data may guide and provide novel insights to the inflammatory mechanisms involved in diabetic subjects and could be considered as future biomarkers to identify patient groups at risk for disease exacerbation.