<b>Objective:</b> 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.
<p><b>Research Design and
Methods: </b>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.<b>
</b>The<b> </b>incidences of PDR, TRD, and NVG were computed at 5 years following
index diagnosis of type 2 diabetes.<b> </b>Associations
between these outcomes and demographic, socioeconomic, and medical factors were
tested with multivariable logistic regression.</p>
<p><b>Results:</b> 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. </p>
<p><b>Conclusions:</b> 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.</p>