Article Text
Abstract
Objective To determine the prevalence of diabetic retinopathy (DR) and diabetic macular oedema (DME) and their associated risk factors in patients recently diagnosed with type 2 diabetes.
Methods and analysis We carried out a cross-sectional study from April 2014 to August 2017. We included patients aged ≥18 years. Diabetes was defined as fasting plasma glucose of >7.8 mmol/L or 2-hour postload plasma glucose of >11.1 mmol/L. Non-mydriatic fundus examination with a digital-fundus camera was performed. Three images centred in the macula, optic disc and temporal to the macula were obtained and graded according to the Scottish Scale Classification of Diabetic Retinopathy.
Results 1232 patients (mean age 51.5 years) with a diabetes duration of 0–5 years were examined. Age-adjusted and sex-adjusted prevalence of DR and DME was 17.4% (95% CI 15.3% to 19.6%) and 6.6% (95% CI 5.4% to 8.2%), respectively. DR was associated with diabetes duration (OR per year=1.20, p<0.001), haemoglobin A1c (HbA1c) from 7.0 to 8.9 (OR=2.19, p<0.001), HbA1c≥9 (OR=2.98, p<0.001) and systolic blood pressure (SBP) (OR=1.16 per 5 mm Hg, p<0.001). DME was associated with diabetes duration (OR per year=1.26, p<0.01), HbA1c from 7.0 to 8.9 (OR=2.26, p<0.05), HbA1c≥9 (OR=2.38, p<0.01), SBP (OR per mm Hg=1.15, p<0.001) and albuminuria (OR=2.45, p<0.01).
Conclusion Our study contributes to the evidence of progressive increase in DR and DME risk in early stages of diabetes, supporting the urgent need for early screening.
- macula
- retina
- epidemiology
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Footnotes
Presented at Part of this study was presented as an oral presentation at the 2016 World Ophthalmology Meeting, 5–9 February 2016, Guadalajara, Mexico.
Contributors EOG-H and AJ-C designed the study, researched the data, conducted the data analysis and wrote the manuscript. DR-D-L-P researched the data, reviewed and edited the manuscript and contributed to the discussion. CAA-S, SH-J and DK-S reviewed the manuscript and contributed to the discussion. AJ-C is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Funding This study was supported by the National Institute of Medical Sciences and Nutrition, Salvador Zubiran, by the Institute of Ophthalmology Conde de Valenciana in México City, México, and by the Fondo Sectorial de Investigación en Salud y Seguridad Social SS/IMSS/ISSSTE-CONACYT, National Council of Science and Technology from Mexico (grant FOSISS-SALUD-2014-01-234409).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The institutional review boards of research, ethics, and biosecurity from the National Institute of Medical Sciences and Nutrition, Salvador Zubiran, and the Institute of Ophthalmology Conde de Valenciana approved the study protocol. All participants signed written informed consent.
Provenance and peer review Not commissioned; externally peer reviewed.