Predicting the risk of diabetic retinopathy in type 2 diabetic patients

Semeraro, Francesco; Parrinello, Giovanni; Cancarini, Anna; Pasquini, Luisa; Zarra, Emanuela; Cimino, Antonio; Cancarini, Giovanni; Valentini, Umberto; Costagliola, Ciro

doi:10.1016/j.jdiacomp.2010.12.002

Cited by 76 publications

(67 citation statements)

References 33 publications

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“…This pattern suggests that, at least in some cases, the true onset of diabetes may have occurred before its initial clinical diagnosis, as described previously [21], [22], [23], which would be consistent with the fact that duration of diabetes is one of the most important determinants of ocular complications [2], [3], [24], [25].…”

Section: Discussionsupporting

confidence: 86%

Incidence of Retinal Complications in a Cohort of Newly Diagnosed Diabetic Patients

et al. 2014

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PurposeWe aimed at estimating the incidence of diabetic retinopathy (DR) and maculopathy (DMP) among newly diagnosed type 1 (t1DM) and type 2 diabetic patients (t2DM) in the United Kingdom primary care system. The incidence of DMP among patients with DR was also estimated.MethodWe conducted a cohort study using The Health Improvement Network database. The cohort included 64,983 incident diabetic patients (97.3% were t2DM) aged 1–84 years diagnosed between 2000 and 2007. This cohort was followed from the date of diabetes diagnosis until recording of DR or DMP in two separate follow-ups. Follow-up was censored at 85 years of age, death, or end of 2008. An additional follow-up was conducted from DR to DMP diagnosis using similar censoring reasons. DR and DMP cumulative incidences were calculated as well as incidence rates (IR; cases per 1,000 person-years) per calendar period (2000–2001 and 2006–2007).ResultsFollow-up for DR: 9 years after diabetes diagnosis, 28% of t2DM and 24% of t1DM patients had developed DR (7,899 incident DR cases). During the first 2 years with diabetes, the IR was almost 2 times higher in patients diagnosed with diabetes in 2006–2007 (47.7) than among those diagnosed in 2000–2001 (24.5). Follow-up for DMP: 9 years after diabetes diagnosis, 3.6% of t2DM and 4.4% of t2DM patients had developed DMP (912 incident DMP cases). During the first 2 years with diabetes, the IR was three times higher in patients diagnosed with diabetes in 2006–2007 (5.8) than among those diagnosed in 2000–2001 (1.8). Macular oedema occurred in 0.8% of patients.ConclusionsIn a cohort of incident diabetes, 28% of patients developed retinopathy and 4% maculopathy within the first 9 years. The 2-year IRs of DR and DMP were higher in patients diagnosed with diabetes during the period 2006–2007 than in those diagnosed during the 2000–2001 period.

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Section: Discussionsupporting

confidence: 86%

Incidence of Retinal Complications in a Cohort of Newly Diagnosed Diabetic Patients

et al. 2014

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“…Similarly, in several studies, no association was found between DR and gender, age or age group [27–31]. However, some reports have found an independent association in males [18, 32, 33], while a historical cohort of Kajiwara et al [34], presented greater chance of DR among females. Yet, in disagreement with the present study, Al-Sarraf et al [35] observed a greater chance of DR in individuals aged 50–59 years (OR 2.2, 95 % CI 1.1–5.2) and ≥60 years (OR 4.6, 95 % CI 11.0–2.0).…”

Section: Discussionmentioning

confidence: 86%

“…Chronic hyperglycemia is responsible for a chain of events that leads to DR [43] and glycemic control one of the key points of primary prevention for this complication [29, 44, 45]. Strong evidences indicate an adequate glycemic control in levels of HbA1c ≤7 % as a reducer of risk for DR, both in type 1 DM and in type 2 DM [32, 46, 47]. Accordingly to a longitudinal study [28], there was an association between DR and poor glycemic control showing higher OR for intervals of 5, 10 and 15 years of 8.34, 3.45 and 4.9, respectively.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for diabetic retinopathy: a case–control study

et al. 2016

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BackgroundDiabetic retinopathy (DR) is the major cause of blindness among working age adults. The aim of the study was to investigate risk factors for development of DR.MethodsA case–control study was performed based on data from 240 individuals (80 cases and 160 controls) attending the Outpatient Specialty Clinic of the University of South Santa Catarina (UNISUL), between Mar/2010 and May/2014. Data collection occurred through review of medical charts for presence or absence of DR, determined by an ophthalmologist. Study protocol included demographic characteristics, metabolic control, diabetes mellitus (DM) profile and comorbidities. Statistical analysis used Chi square test for qualitative variables and multivariate logistic regression analysis to select independent variables (SPSS®18.0 software). Odds ratio (OR) was used as measure of association. The study was approved by research ethics committee of UNISUL.ResultsMean age of group case was 59.5 years with a slight female predominance. Gender, age, body mass index were not associated with outcome. Individuals with poor glycemic control were more likely to DR (OR 3.83; 95 % CI 1.57–9.37). It was observed a positive relationship between duration of DM and DR, with higher chances in 11–15 years of disease (OR 7.52, 95 % CI 3.03–18.68) and >15 years (OR 9.01, 95 % CI 3.58–22.66). Regarding comorbidities, only diabetic nephropathy showed higher chance for DR (OR 3.32; 95 % CI 1.62–6.79).ConclusionsDiabetic patients after 10 years of disease with poor glycemic control and nephropathy have a higher chance of DR.

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“…Interpretation of the nomogram in the prediction of DR has been reported in former studies, 35 which included two major parts. In the first part, the exact values of each predictor were vertically linked to a certain point (the first row of the nomogram), and the total points of each predictor were calculated.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of diabetic retinopathy and sight-threatening diabetic retinopathy: a cross-sectional study of 13 473 patients with type 2 diabetes mellitus in mainland China

et al. 2017

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ObjectiveTo explore the risk factors of diabetic retinopathy (DR) and sight-threatening diabetic retinopathy (STDR) among Chinese patients with diabetes.Design, setting and participantsA cross-sectional investigation was performed in eight screening clinics in six provinces across mainland China. Information about the risk factors was recorded in screening clinics. Some risk factors (sex, age, diagnosis age, diabetes duration, systolic blood pressure (SBP), diastolic blood pressure, fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c)) were recorded in all eight clinics, while others were collected only in a subset of the clinics. The relationships between the risk factors and DR and between the risk factors and STDR were explored for the eight factors mentioned above and for all factors studied.Main outcomes and measuresRisk factors of DR and STDR were assessed, and a nomogram of the results was produced.ResultsYounger age, longer diabetes duration, higher SBP, higher FBG and higher HbA1c were found to be independent risk factors for both DR and STDR in the eight-factor analyses. In the all-factor analysis, younger age, longer diabetes duration, higher SBP, oral medicine use and insulin use were independent risk factors for both DR and STDR; higher postprandial blood glucose (PBG), HbA1c, triglyceride andlow-density lipoprotein were independent risk factors for DR only, and higher FBG was a risk factor for STDR only.ConclusionsIn this cross-sectional investigation, several risk factors were found for DR and STDR. Notably, FBG, PBG and HbA1c were all risk factors for DR or STDR, suggesting that stricter blood glucose control in clinical practice is required.

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Predicting the risk of diabetic retinopathy in type 2 diabetic patients

Cited by 76 publications

References 33 publications

Incidence of Retinal Complications in a Cohort of Newly Diagnosed Diabetic Patients

Incidence of Retinal Complications in a Cohort of Newly Diagnosed Diabetic Patients

Risk factors for diabetic retinopathy: a case–control study

Risk factors of diabetic retinopathy and sight-threatening diabetic retinopathy: a cross-sectional study of 13 473 patients with type 2 diabetes mellitus in mainland China

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