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Diabetes Res Clin Pract. 2017 Nov;133:21-29. doi: 10.1016/j.diabres.2017.08.009. Epub 2017 Aug 24.

Overweight, hyperglycemia and tobacco use are modifiable risk factors for onset of retinopathy 9 and 17years after the diagnosis of diabetes - A retrospective observational nation-wide cohort study.

Author information

1
Department of Ophthalmology, Helsingborg Hospital, Lund University, Helsingborg, Sweden.
2
Department of Public Health and Clinical Medicine, Epidemiology, Umeå University, Umeå, Sweden.
3
Department of Endocrinology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
4
Department of Endocrinology, Metabolism, and Diabetes, Karolinska University Hospital Huddinge, Karolinska Institutet, Sweden.
5
Department of Medicine, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
6
Department of Clinical Sciences, Lund University, Lund, Sweden.
7
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
8
Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Electronic address: maria.k.svensson@medsci.uu.se.

Abstract

BACKGROUND:

The aims of this study were to estimate the risk for diabetic retinopathy (DR) and to identify risk factors. We investigated a nationwide population-based cohort with diabetes diagnosed at age 15-34years.

PATIENTS AND METHODS:

Of 794 patients registered 1987-1988 in the Diabetes Incidence Study in Sweden (DISS) 444 (56%) patients with retinal photos available for classification of retinopathy participated in a follow-up study 15-19 (median 17) years after diagnosis. Mean age was 42.3±5.7years, BMI 26.1±4.1kg/m2, 62% were male and 91% had type 1 diabetes. A sub-study was performed in 367 patients with retinal photos from both the 9 and 17year follow up and the risk for development of retinopathy between 9 and 17years of follow up was calculated.

RESULTS:

After median 17years 324/444 (73%, 67% of T1D and 71% of T2D), had developed any DR but only 5.4% proliferative DR. Male sex increased the risk of developing retinopathy (OR 1.9, 95% CI 1.2-2.9). In the sub-study obesity (OR 1.2, 95% CI 1.04-1.4), hyperglycemia (OR 2.5, 95% CI 1.6-3.8) and tobacco use (OR 2.9, 95% CI 1.1-7.3) predicted onset of retinopathy between 9 and 17years after diagnosis of diabetes.

CONCLUSION:

The number of patients with severe retinopathy after 17years of diabetes disease was small. The risk of developing retinopathy with onset between 9 and 17years after diagnosis of diabetes was strongly associated to modifiable risk factors such as glycemic control, obesity and tobacco use.

PMID:
28888147
DOI:
10.1016/j.diabres.2017.08.009
[Indexed for MEDLINE]

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