Factors predicting retinopathy in Type 2 diabetics identified

Source: MedWire News

Pharmacologic treatment for diabetes, male gender, and elevated glycated hemoglobin (HbA1c) all significantly increase the risk for diabetic retinopathy in patients with Type 2 diabetes, say researchers.

A smaller, but still significant association was also observed between diabetic retinopathy and longer duration of diabetes, high systolic blood pressure, and presence of albuminuria.

Diabetic retinopathy can be sight-threatening in its later stages, especially without treatment, explain Ciro Costagliola (University of Molise, Campobasso, Italy) and colleagues. However, it can still be asymptomatic even when advanced, making early detection vital.

Costagliola and team analyzed data from 5034 patients (40% female) with Type 2 diabetes who were followed-up between 1996 and 2007 and who had no retinopathy on recruitment. The participants, aged an average of 61 years, had a mean duration of diabetes of 2 years and an average HbA1c of 7.42% on enrollment.

Diabetic retinopathy occurred in 569 (11%) of the patients during follow-up. The researchers found that treatment with an oral antidiabetes medication, insulin, or a combination of both significantly increased the risk for retinopathy 3.90-, 6.79-, and 8.86-fold, respectively, compared with diet alone.

Male gender significantly increased the risk 1.31-fold and each percentage increase in HbA1c increased the risk for retinopathy 1.16-fold.

Other factors that also significantly predicted retinopathy, albeit to a lesser degree, included duration of diabetes, with a 1.06-fold increase for every additional year of the disease; and systolic blood pressure, with a 1.01-fold increased risk associated with each additional mmHg increase.

Finally, presence of albuminuria was associated with a borderline significant increase in risk for retinopathy.

"Prevention, early detection, and intervention may prevent onset of diabetic retinopathy and reduce the likelihood of diabetic retinopathy progression," write the authors in the Journal of Diabetes and its Complications.

They suggest that these risk factors could be used to create a tool for predicting diabetic retinopathy in asymptomatic patients. They say that the ability to "quickly identify patients at risk to develop diabetic retinopathy allows us to save resources for medical, social, and personal costs in preserving eyesight."