Incidence of and risk factors for cataract among diabetes clinic attenders

Abstract

The incidence of and risk factors for cataract during a mean (standard deviation (SD)) follow-up period of 5.0 (3.0) (range 0.1-12.4) years were examined among 3606 patients (2001 male and 1605 female) with diabetes mellitus from three outpatient clinics at the University Hospital, Nottingham. Among the 3606 patients free of cataract at initial registration who attended the clinic at least twice in the period 1979-1992, the mean (SD) age was 49.2 (17.8) years with a mean (SD) duration of diabetes of 7.6 (9.8) years at initial registration. The incidence of cataract was 10.4 (95% confidence interval (CI), 9.0, 11.9) per 1000 person-years based on 18089 person-years of follow-up. The incidence for females (13.6 (95% CI, 11.0, 16.1)) was greater than in males (8 (95% CI, 6.3, 9. 7)) (P<0.001). The incidence of cataract in insulin-dependent diabetes mellitus (IDDM), non-insulin-treated and insulin-treated non-insulin-dependent diabetes mellitus (NIDDM) were 7.1 (95% CI, 5. 4, 8.9), 11.7 (95% CI, 9.1, 14.3) and 17.8 (95% CI, 12.9, 22.7) per 1000 person-years, respectively. Age-adjustment substantially changed the ordering of risk associated with different types of diabetes. Using a Cox's Proportional Hazards Model for IDDM and NIDDM (insulin and non-insulin-treated) diabetes separately, age and any retinopathy were significant independent predictors of cataract for all groups. Poor metabolic control also was a significant independent predictor of cataract for the IDDM and insulin-treated NIDDM diabetes groups. Duration of diabetes was a significant independent predictor of cataract for the IDDM group. Age at diagnosis of diabetes, systolic and diastolic blood pressure, body mass index, proteinuria, cigarette smoking and creatinine had no significant independent association with cataract when other covariates were considered. These findings will help the identification of those diabetic patients at particular risk of cataract so that clinic time for screening of eyes can be appropriately focused and health care planning for people with diabetes considered.

Smoking and cataract: Review of causal association

“…Age is an accepted risk factor for cataract, and 12 studies accounted or controlled for age or for age and sex in their analyses. Nine studies found an association between smoking and cataract, 11,[20][21][22][23]31,34,35,40 and only 3 studies 25,36,38 found no association after adjustment for age.…”

“…Although most studies distinguished between nuclear, cortical, and posterior subcapsular cataract, some studies did not and grouped all types together for analysis. 5,9,22,25,26,37,38,49 Standardized criteria for diagnosis of cataract were used in some studies. The Lens Opacities Classification System 50,51 or later updated versions of this system was used in 5 studies.…”

“…9,[19][20][21][22][23]25,26,33,35,37,40 Compared with never smokers, ex-smokers generally also had an increased risk for cataract. The effects of smoking cessation on the incidence of cataract were specifically examined in 2 large U.S. prospective cohort studies.…”

Análisis coste-utilidad de las bombas de insulina frente a múltiples dosis diarias en pacientes con diabetes mellitus tipo 1 en España

“…En la tabla 1 se presentan los diferentes submodelos que se incluyen en el análisis, así como los dife-rentes estados de salud que contemplan cada uno de ellos. Las probabilidades de transición están basadas en diferentes estudios clí-nicos [13][14][15][16][17] y varían con el tiempo y con el perfil de riesgo de la población de estudio.…”

A game changer for eye care for diabetes

“…Cross-sectional findings from the Beaver Dam Eye Study 744 and the POLA Study 745 , indicated associations between diabetes and both cortical and PSC cataract, while the Barbados Eye Study 746 reported an association only with cortical cataract. Many studies, including case reports and population surveys, have also found associations between diabetes and all lens opacities 733 , very early or rapid-onset cortical opacities [747][748][749] , and cataract surgery [750][751][752] .…”