Incidence of Proliferative Diabetic Retinopathy and Other Neovascular Sequelae at 5 Years Following Diagnosis of Type 2 Diabetes

Objective: To determine the incidence and risk factors for developing proliferative diabetic retinopathy (PDR), tractional retinal detachment (TRD), and neovascular glaucoma (NVG) at 5 years after initial diagnosis of type 2 diabetes. Research Design and Methods: Insured patients age 18 or older with newly-diagnosed type 2 diabetes and 5 years of continuous enrollment were identified from a nationwide commercial claims database containing data from 2007-2015. The incidences of PDR, TRD, and NVG were computed at 5 years following index diagnosis of type 2 diabetes. Associations between these outcomes and demographic, socioeconomic, and medical factors were tested with multivariable logistic regression. Results: At 5 years following initial diagnosis of type 2 diabetes, 1.74% (1,249/71,817) of patients had developed PDR. Additionally, 0.25% of patients had developed TRD, and 0.14% of patients had developed NVG. Insulin use (OR 3.59, 95% CI 3.16-4.08), maximum HbA1c >9% or 75mmol/mol (OR 2.10, 95% CI 1.54-2.69), renal disease (OR 2.68, 95% CI 2.09-3.42), peripheral circulatory disorders (OR 1.88, 95% CI 1.25-2.83), neurological disease (OR 1.62, 95% CI 1.24-2.11), and older age at diagnosis (age 65-74, OR 1.62, 1.28-2.03) were identified as risk factors for development of PDR at 5 years. Young age at diagnosis (age 18-34, OR 0.46, 95% CI 0.29-0.74), Medicare insurance (OR 0.60, 95% CI 0.70-0.76), morbid obesity (OR 0.72, 95% CI 0.59-0.87), and smoking (OR 0.84, 95% CI 0.70-1.00) were identified as protective factors. Conclusions: A subset of patients with type 2 diabetes develop PDR and other neovascular sequelae within the first 5 years following diagnosis with type 2 diabetes. These patients may benefit from increased efforts for screening and early intervention.

Download Full-text

Risk Factors For Diabetic Retinopathy Progression

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.1515/rjdnmd-2015-0020 ◽

2015 ◽

Vol 22 (2) ◽

pp. 159-165

Author(s):

Mónika Deák ◽

Monica Lasca ◽

Ioan Andrei Vereşiu

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Smoking Status ◽

Diabetes Duration ◽

Diabetes Diagnosis ◽

Number Of Patients

AbstractBackground and Aims. There is no unanimous opinion regarding the risk factors associated with progression of diabetic retinopathy (DR). We have done a retrospective analysis of risk factors and clinical features associated with DR progression.Material and Methods. This analysis included consecutive patients with moderate non-proliferative or severe retinopathy between December 1, 2013 and May 31, 2014 who had at least two eye examinations before that period. We have collected demographic, clinical and lab data.Results. 51.28% of patients were diagnosed with moderate non-proliferative diabetic retinopathy (NPDR), 24.68% with severe NPDR and 21.05% with proliferative diabetic retinopathy. In 82.16% of cases, DR had progressed. The risk factor correlated with DR progression in the whole group was anemia; hypertension, anemia and diabetes duration were risk factors in type 1 and smoking status at diabetes diagnosis in type 2 diabetes. Total cholesterol, triglycerides, diabetes control and presence of diabetic renal disease were positively but not statistically significant correlated with DR progression.Conclusions. In our study the risk factors correlated with DR progression were hypertension, anemia and diabetes duration in type 1, respectively smoking at diabetes diagnosis in type 2 diabetes. Glycemic goals were achieved in a small number of patients.

Download Full-text

Risk Factors for Proliferative Diabetic Retinopathy in African Americans with Type 2 Diabetes

Ophthalmic Epidemiology ◽

10.3109/09286586.2015.1119287 ◽

2016 ◽

Vol 23 (2) ◽

pp. 88-93 ◽

Cited By ~ 12

Author(s):

Alan Penman ◽

Heather Hancock ◽

Evangelia Papavasileiou ◽

Maurice James ◽

Omolola Idowu ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

African Americans ◽

Proliferative Diabetic Retinopathy

Download Full-text

Incidence, Progression, and Associated Risk Factors of Posterior Vitreous Detachment in Type 2 Diabetes Mellitus: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS II, Report No. 7)

Seminars in Ophthalmology ◽

10.3109/08820538.2015.1047959 ◽

2015 ◽

Vol 32 (2) ◽

pp. 191-197 ◽

Cited By ~ 4

Author(s):

Laxmi Gella ◽

Rajiv Raman ◽

Swakshyar Saumya Pal ◽

Suganeswari Ganesan ◽

Tarun Sharma

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Molecular Genetic ◽

Posterior Vitreous Detachment ◽

Molecular Genetic Study ◽

Associated Risk Factors

Download Full-text

A hemochromatosis-causing mutation C282Y is a risk factor for proliferative diabetic retinopathy in Caucasians with type 2 diabetes

American Journal of Ophthalmology ◽

10.1016/j.ajo.2004.04.035 ◽

2004 ◽

Vol 137 (6) ◽

pp. 1171-1172

Author(s):

B. Peterlin ◽

M. Globočnik Petrovič ◽

J. Makuc ◽

M. Hawlina ◽

D. Petrovič

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Risk Factor ◽

Proliferative Diabetic Retinopathy

Download Full-text

Prevalence of diabetic retinopathy and its relationship with glomerular filtration rate and other risk factors in patients with type 2 diabetes mellitus in Spain. DM2 HOPE study

Journal of Clinical & Translational Endocrinology ◽

10.1016/j.jcte.2017.07.004 ◽

2017 ◽

Vol 9 ◽

pp. 61-65 ◽

Cited By ~ 7

Author(s):

Maribel López ◽

Francesc Xavier Cos ◽

Fernando Álvarez-Guisasola ◽

Eva Fuster

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate

Download Full-text

Serum levels of mac-2 binding protein are associated with diabetic microangiopathy and macroangiopathy in people with type 2 diabetes

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001189 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001189

Author(s):

Yoshitaka Hashimoto ◽

Masahide Hamaguchi ◽

Ayumi Kaji ◽

Ryosuke Sakai ◽

Noriyuki Kitagawa ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Liver Fibrosis ◽

Proliferative Diabetic Retinopathy ◽

Binding Protein ◽

Protein Glycosylation ◽

Diabetic Microangiopathy ◽

Alcoholic Fatty Liver ◽

Increased Risk

IntroductionNon-alcoholic fatty liver disease is reportedly associated with type 2 diabetes and progressive liver fibrosis, as evaluated by transient elastography, and has been linked with micro- and macroangiopathy in people with type 2 diabetes. The purpose of this cross-sectional study was to investigate the association between serum mac-2 binding protein glycosylation isomer (M2BPGi) levels and diabetic complications in people with type 2 diabetes.Research design and methodsSerum M2BPGi levels were measured in terms of cut-off index (C.O.I.) units. Urinary albumin excretion (UAE) was calculated and nephropathy was graded as normoalbuminuria, microalbuminuria, or macroalbuminuria. Retinopathy was divided into three groups: no-diabetic retinopathy (NoDR), non-proliferative-diabetic retinopathy (NPDR), or proliferative-diabetic retinopathy (PDR) .ResultsThe mean age for the 363 studied subjects (212 males) was 66.4±10.6 years, the median serum M2BPGi level was 0.77 (0.57–1.04) C.O.I., and the median UAE was 22 (9–82.1) mg/g creatinine. M2BPGi levels in microalbuminuria (0.83 (0.61 to 1.18) C.O.I.) and macroalbuminuria (0.88 (0.67 to 1.22) C.O.I.) cases were higher than those in normoalbuminuria cases (0.71 (0.54 to 0.92) C.O.I.). M2BPGi levels in NPDR (0.93 (0.68 to 1.28) C.O.I.) and PDR (0.95 (0.71 to 1.31) C.O.I.) cases were higher than in cases with NoDR (0.73 (0.56 to 0.99) C.O.I.). Furthermore, M2BPGi levels in subjects with a history of cardiovascular diseases were higher than in those with no such history (0.82 (0.65 to 1.22) vs 0.76 (0.55 to 1.03) C.O.I., p=0.019). The logarithm of (M2BPGi+1) was associated with the logarithm of UAE values after adjusting for covariates (standardized β=0.107, p=0.031).ConclusionsThis study reveals a close association between serum M2BPGi levels and diabetic microangiopathy and macroangiopathy in people with type 2 diabetes. The results also show that liver fibrosis, evaluated by M2BPGi, is independently associated with an increased risk of albuminuria.

Download Full-text

Vascular endothelial growth factor (VEGF)-related polymorphisms rs10738760 and rs6921438 are not risk factors for proliferative diabetic retinopathy (PDR) in patients with type 2 diabetes mellitus (T2DM)

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2018.3519 ◽

2019 ◽

Vol 19 (1) ◽

pp. 94-100 ◽

Cited By ~ 3

Author(s):

Jana Sajovic ◽

Ines Cilenšek ◽

Sara Mankoč ◽

Špela Tajnšek ◽

Tanja Kunej ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Vascular Endothelial Growth Factor ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Diabetic Patients ◽

Vascular Endothelial ◽

Endothelial Growth Factor

Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis and has been investigated as a candidate gene in a number of conditions, including diabetes and its microvascular complications (e.g., retinopathy and nephropathy). Several VEGF-related polymorphisms have been shown to contribute to nearly half of the variability in circulating VEGF levels in healthy individuals. Our aim was to assess the association between VEGF-related rs10738760 and rs6921438 polymorphisms and proliferative diabetic retinopathy (PDR) in Slovenian patients with type 2 diabetes mellitus (T2DM). We also investigated the effect of these polymorphisms on VEGF receptor 2 (VEGFR-2) expression in fibrovascular membranes (FVMs) from patients with PDR. This case-control study enrolled 505 unrelated patients with T2DM: 143 diabetic patients with PDR as a study group, and 362 patients with T2DM of >10 years duration and with no clinical signs of PDR as a control group. Patient clinical and laboratory data were obtained from their medical records. rs10738760 and rs6921438 polymorphisms were genotyped using TaqMan SNP Genotyping assay. VEGFR-2 expression was assessed by immunohistochemistry in 20 FVMs from patients with PDR, and numerical areal density of VEGFR-2-positive cells was calculated. The occurrence of PDR was 1.7 times higher in diabetic patients carrying GA genotype of rs6921438 compared to patients with GG genotype, with a borderline statistical significance (OR = 1.7, 95% CI = 1.00 – 2.86, p = 0.05). In addition, A allele of rs6921438 was associated with increased VEGFR-2 expression in FVMs from PDR patients. However, we observed no association between AA genotype of rs6921438 nor between rs10738760 variants and PDR, indicating that the two polymorphisms are not genetic risk factors for PDR.

Download Full-text