Prevalence and progression rate of diabetic retinopathy in type 1 diabetes patients in correlation with the duration of diabetes

Abstract Introduction. 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. Methods. 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. Results. 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). Conclusions. In type 1 diabetes patients insulin resistance was the most important independent risk factor associated with diabetic proliferative retinopathy.

Download Full-text

562-P: Influence of Glycemic Control and Variability on Diabetic Retinopathy in Type 1 Diabetes Patients on Continuous Subcutaneous Insulin Infusion Therapy

Diabetes ◽

10.2337/db20-562-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 562-P

Author(s):

EDURNE LECUMBERRI ◽

NURIA BENGOA ◽

MARÍA FERNÁNDEZ ARGÜESO ◽

LÍA NATTERO CHÁVEZ

Keyword(s):

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Glycemic Control ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Infusion Therapy ◽

Subcutaneous Insulin ◽

Diabetes Patients

Download Full-text

The Relationship between Serum Carbonic Anhydrase 1-2 Autoantibody Levels and Diabetic Retinopathy in Type 1 Diabetes Patients

Turkish Journal of Ophthalmology ◽

10.4274/tjo.99233 ◽

2017 ◽

Vol 47 (2) ◽

pp. 85-88

Author(s):

Adem Türk ◽

Süleyman Mollamehmetoğlu ◽

Ahmet Alver ◽

Ahmet Menteşe ◽

İrfan Nuhoğlu ◽

...

Keyword(s):

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Carbonic Anhydrase ◽

The Relationship ◽

Carbonic Anhydrase 1 ◽

Diabetes Patients

Download Full-text

Diabetic retinopathy in type 1 diabetes patients in Western Norway

Acta Ophthalmologica ◽

10.1111/aos.13654 ◽

2018 ◽

Vol 96 (5) ◽

pp. 465-474 ◽

Cited By ~ 7

Author(s):

Ragnhild W. Jansson ◽

Karl Ove Hufthammer ◽

Jørgen Krohn

Keyword(s):

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Western Norway ◽

Diabetes Patients

Download Full-text

Association between Serum Vitamin D and Diabetic Retinopathy in Portuguese Patients with Type 1 Diabetes

Acta Médica Portuguesa ◽

10.20344/amp.12890 ◽

2020 ◽

Vol 33 (7-8) ◽

pp. 459

Author(s):

Miguel Lopes ◽

Rita Laiginhas ◽

Carolina Madeira ◽

João Sérgio Neves ◽

Margarida Barbosa ◽

...

Keyword(s):

Vitamin D ◽

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Metabolic Control ◽

Serum Vitamin ◽

Duration Of Diabetes ◽

Hydroxyvitamin D ◽

Serum Vitamin D ◽

25 Hydroxyvitamin D

Introduction: Recently, vitamin D has gained importance as a diabetes risk modifier. Our aim was to assess the association between serum vitamin D levels and the prevalence of diabetic retinopathy in patients with type 1 diabetes.Material and Methods: Retrospective review of a population of patients with type 1 diabetes followed in a Portuguese tertiary center. Patients were included if they had an ophthalmological evaluation and a serum 25-hydroxyvitamin D level determination within the same year. Logistic regression analysis was used to adjust for possible confounders.Results: We included 182 patients (47% male), and 57% (n = 103) had signs of diabetic retinopathy. We found a significant association between lower circulating levels of 25-hydroxyvitamin D levels and a greater prevalence of diabetic retinopathy after adjusting for confounders (duration of diabetes, estimated glomerular filtration rate, age, sex, metabolic control, season, dyslipidemia and hypertension) (OR = 0.94; 95% CI 0.90 - 0.99, p = 0.023). Longer duration of diabetes and worse metabolic control also remained associated with diabetic retinopathy in the multivariate analysis (OR = 1.20; 95% CI 1.13 - 1.27, p < 0.001 and OR = 4.13; 95% CI 1.34 - 12.7, p = 0.013, respectively).Conclusion: Lower levels of vitamin D were associated with an increased prevalence of diabetic retinopathy in patients with type 1 diabetes, after adjusting for possible confounders. Future controlled studies may elucidate the molecular routes for this association as well as the role of supplementation in the prevention of diabetes microvascular complications.

Download Full-text

The association between high-sensitive c-reactive protein and retinal hemodynamics in type 1 diabetes patients with non-proliferative diabetic retinopathy

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2010.4116.x ◽

2010 ◽

Vol 88 ◽

pp. 0-0

Author(s):

B PEMP ◽

G GARHOFER ◽

M LASTA ◽

D SCHMIDL ◽

L SCHMETTERER

Keyword(s):

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

C Reactive Protein ◽

Reactive Protein ◽

Diabetes Patients

Download Full-text

Diabetic Retinopathy. Association with Metabolic Compensation, Duration of Diabetes and Other Micro and Macrovascular Complications in Patients with Type 1 Diabetes Mellitus

Acta Chirurgica Latviensis ◽

10.2478/chilat-2020-0015 ◽

2020 ◽

Vol 18 (1) ◽

pp. 56-62

Author(s):

Lelde Ullase ◽

Kristīne Ducena ◽

Dace Markevica ◽

Guna Laganovska

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Type 1 Diabetes Mellitus ◽

Vision Loss ◽

Microvascular Complications ◽

Duration Of Diabetes ◽

Metabolic Compensation ◽

Significant Difference

SummaryIntroductionDiabetic retinopathy (DR) is a severe complication that can lead to complete vision loss and still is one of the main blindness-causing reasons among patients with type 1 diabetes mellitus (T1DM). DR as a complication can cause vision loss to people at their working age. More than 90% of patients with type 1 diabetes will develop DR by 20 years post diagnosis (Leslie R. Dye, 2018). DR is more likely to develop in patients with T1DM (Kanski's Clinical Ophthalmology, 2016). This complication can be very serious speaking of the ability to see. Sometimes vitrectomy plays a vital role in the management of severe complications of DR at its end-stage (Myron Yanoff et al., 2020).Aim of the studyTo prove the development severity of DR that depends on the duration of diabetes and metabolic compensation. Additionally, to determine retinopathy's association with other micro and macrovascular diabetes mellitus complications for a better understanding of what are the contributory factors for these complications to develop and which of those may coexist.Materials and MethodsA retrospective study was held at the Pauls Stradins Clinical University Hospital (Riga, Latvia). From January 2016 to March 2018, 79 (158 eyes) patient histories were analyzed who have type 1 diabetes mellitus. To obtain more precise research results, almost all patients have done check-up visits to one certain ophthalmologist. The IBM SPSS Statistics version 25.0 was used to process data. Tables were made in SPSS and Microsoft Excel 2016 programs. Statistically significant value (p) was set at < 0,05.ResultsNo statistically significant difference is seen in the mean duration of the disease: in the group of proliferative diabetic retinopathy (PDR): 25.23 (median = 22.0) years and non-proliferative group: 24.68 (median = 23.50) years. Results show that the duration of diabetes mellitus is considerably smaller in a group without DR 11.24 (median = 8.50) years. Metabolic compensation (%) in diabetes mellitus is not statistically different between patients with diverse forms of DR; no association found either. No statistically significant difference in best corrected visual acuity (BCVA) was detected among patients with various forms of DR. Three groups were compared: both types of DR and no DR. It was detected that BCVA in patients without DR was higher in both eyes: 0.83 ± 0.27 dioptres. No statistically significant difference (pχ > 0.05) was detected between the groups of DR and therefore no association was made between the form/existence of DR and arterial hypertension. There is a strong association between DR and microvascular complications (V = 0.40) with the existence of DR and there is an even stronger association (V = 0.61) with the forms of DR. There is no statistically reliable difference (pχ > 0.05) between the groups of DR; therefore, no association with the existence of microvascular complications and also risk factors.ConclusionsMore than two-thirds of patients included in the research have some signs of DR. Because of the strong association of DR and other microvascular complications, patients with diabetes should be screened regularly for retinopathy, nephropathy, and neuropathy. And likewise, if a patient has at least one microvascular complication, he or she should be tested for the rest possible complications as well. According to data, most of the patients in this study have poor metabolic compensation; consequently, the metabolic compensation screening should be done certainly every three months.

Download Full-text

HbA1c level as a risk factor for retinopathy and nephropathy in children and adults with type 1 diabetes: Swedish population based cohort study

BMJ ◽

10.1136/bmj.l4894 ◽

2019 ◽

pp. l4894 ◽

Cited By ~ 16

Author(s):

Marcus Lind ◽

Aldina Pivodic ◽

Ann-Marie Svensson ◽

Arndis F Ólafsdóttir ◽

Hans Wedel ◽

...

Keyword(s):

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Cohort Study ◽

Relative Risk ◽

Confidence Interval ◽

Severe Hypoglycaemia ◽

Population Based ◽

Duration Of Diabetes ◽

Increased Risk

AbstractObjectiveTo evaluate if the lowest target level for glycated haemoglobin (HbA1c) of <6.5% is associated with lower risk for retinopathy and nephropathy than less tight control in children and adults with type 1 diabetes.DesignPopulation based cohort study.SettingSwedish National Diabetes Registry, 1 January 1998 to 31 December 2017.Participants10 398 children and adults with type 1 diabetes followed from diagnosis, or close thereafter, until end of 2017.Main outcome measuresRelative risk (odds ratios) for retinopathy and nephropathy for different mean levels of HbA1c.ResultsMean age of participants was 14.7 years (43.4% female), mean duration of diabetes was 1.3 years, and mean HbA1c level was 8.0% (63.4 mmol/mol). After adjustment for age, sex, duration of diabetes, blood pressure, blood lipid levels, body mass index, and smoking, the odds ratio for mean HbA1c <6.5% (<48 mmol/mol) compared with 6.5-6.9% (48-52 mmol/mol) for any retinopathy (simplex or worse) was 0.77 (95% confidence interval 0.56 to 1.05, P=0.10), for preproliferative diabetic retinopathy or worse was 3.29 (0.99 to 10.96, P=0.05), for proliferative diabetic retinopathy was 2.48 (0.71 to 8.62, P=0.15), for microalbuminuria or worse was 0.98 (0.60 to 1.61, P=0.95), and for macroalbuminuria was 2.47 (0.69 to 8.87, P=0.17). Compared with HbA1c levels 6.5-6.9%, HbA1c levels 7.0-7.4% (53-57 mmol/mol) were associated with an increased risk of any retinopathy (1.31, 1.05 to 1.64, P=0.02) and microalbuminuria (1.55, 1.03 to 2.32, P=0.03). The risk for proliferative retinopathy (5.98, 2.10 to 17.06, P<0.001) and macroalbuminuria (3.43, 1.14 to 10.26, P=0.03) increased at HbA1c levels >8.6% (>70 mmol/mol). The risk for severe hypoglycaemia was increased at mean HbA1c <6.5% compared with 6.5-6.9% (relative risk 1.34, 95% confidence interval 1.09 to 1.64, P=0.005).ConclusionsRisk of retinopathy and nephropathy did not differ at HbA1c levels <6.5% but increased for severe hypoglycaemia compared with HbA1c levels 6.5-6.9%. The risk for severe complications mainly occurred at HbA1c levels >8.6%, but for milder complications was increased at HbA1c levels >7.0%.

Download Full-text