Prevalence and associated risk factors of diabetic retinopathy and macular oedema in patients recently diagnosed with type 2 diabetes

Abstract

ObjectiveTo determine the prevalence of diabetic retinopathy (DR) and diabetic macular oedema (DME) and their associated risk factors in patients recently diagnosed with type 2 diabetes.Methods and analysisWe carried out a cross-sectional study from April 2014 to August 2017. We included patients aged ≥18 years. Diabetes was defined as fasting plasma glucose of >7.8 mmol/L or 2-hour postload plasma glucose of >11.1 mmol/L. Non-mydriatic fundus examination with a digital-fundus camera was performed. Three images centred in the macula, optic disc and temporal to the macula were obtained and graded according to the Scottish Scale Classification of Diabetic Retinopathy.Results1232 patients (mean age 51.5 years) with a diabetes duration of 0–5 years were examined. Age-adjusted and sex-adjusted prevalence of DR and DME was 17.4% (95% CI 15.3% to 19.6%) and 6.6% (95% CI 5.4% to 8.2%), respectively. DR was associated with diabetes duration (OR per year=1.20, p<0.001), haemoglobin A1c (HbA1c) from 7.0 to 8.9 (OR=2.19, p<0.001), HbA1c≥9 (OR=2.98, p<0.001) and systolic blood pressure (SBP) (OR=1.16 per 5 mm Hg, p<0.001). DME was associated with diabetes duration (OR per year=1.26, p<0.01), HbA1c from 7.0 to 8.9 (OR=2.26, p<0.05), HbA1c≥9 (OR=2.38, p<0.01), SBP (OR per mm Hg=1.15, p<0.001) and albuminuria (OR=2.45, p<0.01).ConclusionOur study contributes to the evidence of progressive increase in DR and DME risk in early stages of diabetes, supporting the urgent need for early screening.

High glucose treatment promotes extracellular matrix proteome remodeling in Müller glial cells

“…Interestingly, it has been shown that supplemented SPP1 inhibits experimentally induced osmotic swelling in ex vivo rat RMG ( Wahl et al, 2013 ). Glial swelling is involved in pathology of diabetic macula edema, a severe complication of DR ( Coughlin, Feenstra & Mohr, 2017 ; Daruich et al, 2018 ; Graue-Hernandez etal., 2020 ; Wahl et al, 2013 ). We speculate that a decrease in SPP1 expression level might contribute to RMG swelling in diabetic macular edema.…”

“…The worldwide prevalence for diabetes in adults is increasing and is predicted to exceed ten percent of world population by 2040 ( Ogurtsova et al, 2017 ). Diabetic retinopathy (DR) is a severe and frequent comorbidity of diabetes and a leading cause of vision loss ( Ducos et al, 2020 ; Graue-Hernandez etal., 2020 ; Leasher et al, 2016 ). However, the underlying pathomechanisms remain to be comprehensively elucidated ( Mesquida, Drawnel & Fauser, 2019 ).…”

Peer Review #2 of "High glucose treatment promotes extracellular matrix proteome remodeling in Müller glial cells (v0.1)"

“…Interestingly, it has been shown that supplemented SPP1 inhibits experimentally induced osmotic swelling in ex vivo rat RMG (Wahl et al 2013). Glial swelling is involved in pathology of diabetic macula edema, a severe complication of DR (Coughlin et al 2017;Daruich et al 2018;Graue-Hernandez et al 2020;Wahl et al 2013). We speculate that a decrease in SPP1 expression level might contribute to RMG swelling in diabetic macular edema.…”

“…The worldwide prevalence for diabetes in adults is increasing and is predicted to exceed ten percent of world population by 2040 (Ogurtsova et al 2017). Diabetic retinopathy (DR) is a severe and frequent comorbidity of diabetes and a leading cause of vision loss (Ducos et al 2020;Graue-Hernandez et al 2020;Leasher et al 2016). However, the underlying pathomechanisms remain to be comprehensively elucidated (Mesquida et al 2019).…”

Alcance en el uso de cámara no midriática para la evaluación de fondo de ojo de sujetos con diabetes

“…Aunque el tamaño de muestra no fue amplio, la proporción de pacientes diabéticos que presentó retinopatía diabética fue semejante a la reportada por otros estudios en nuestra población (27 vs. 17.3% 13 ) y en poblaciones de otros países 14,15 . A pesar del tiempo y las estrategias utilizadas para el control de la enfermedad, no se ha logrado disminuir la frecuencia de esta complicación; sin embargo, sí se ha reportado una disminución en la frecuencia de casos con lesiones que pongan en riesgo la función visual 16,17 .…”