• Endocrine · Nov 2019

    Observational Study

    Risk factors for prevalent diabetic retinopathy and proliferative diabetic retinopathy in type 1 diabetes.

    • Rita Laiginhas, Carolina Madeira, Miguel Lopes, João Sérgio Neves, Margarida Barbosa, Vitor Rosas, Davide Carvalho, Fernando Falcão-Reis, and Manuel Falcão.
    • Faculty of Medicine, Porto University, Porto, Portugal.
    • Endocrine. 2019 Nov 1; 66 (2): 201-209.

    PurposeAge at diagnosis of type 1 diabetes (DM1) has been implied as an important factor associated with the development of the microvascular complications. Our aim was to identify factors associated with prevalent diabetic retinopathy (DR) and proliferative diabetic retinopathy (PDR) in DM1 people with early and late-onset.MethodsWe reviewed medical records from all DM1 people from the reference area of a tertiary center (about 340,000 persons). Univariate and multivariate logistic regression were used to assess the relationship between potential risk factors (sociodemographic, diabetes-related, co-morbidities, and laboratory parameters) and prevalent DR/PDR. We performed an analysis comparing patients diagnosed before (early-onset) and after (late-onset) 18 years of age.ResultsWe included 140 patients in early-onset DM1 group and 169 in late-onset DM1 group. Longer duration of diabetes and HbA1c remained associated with prevalent DR in both groups after adjusting for potential risk factors. Nephropathy was associated with prevalent DR in the late-onset group but not in the early-onset group. Peripheral neuropathy remained associated with prevalent PDR when modeled together in the multivariate model. High BMI demonstrated a significative association with PDR in early but not in the late-onset DM1 group.ConclusionsAlthough previous reports suggest that age at DM1 diagnosis may have a role in DR prevalence, the risk factors for DR in early and late-onset DM1 were similar for both groups. Duration of disease and lifelong metabolic control were the major predictors for DR in both groups. Nephropathy was associated with DR in patients with late-onset disease. Neuropathy was associated with PDR occurrence in both groups. BMI was associated with PDR early-onset DM1 group.

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