Risk Factors Associated with Diabetic Retinopathy with and without Macular Edema in Recently Diagnosed Patients with Type 2 Diabetes

• Published in: Diabetes, metabolic syndrome and obesity metabolic syndrome and obesity, 2024-01, Vol.17, p.231-238
• Main Authors: Parra, David Rivera-De La, Hernandez-Jimenez, Sergio, Graue-Hernandez, Enrique Octavio, Garcfa-Ulloa, Ana Cristina, Jimenez-Corona, Aida, Jaime-Casas, Salvador, Perez-Peralta, Liliana
• Format: Article
• Language: English
• Subjects: Development and progression; diabetes mellitus; Diabetic retinopathy; Digital photography; Dropsy; Edema; Fenofibrate; Glycosylated hemoglobin; macular edema; metabolic control; recent diagnosis; Risk factors; Type 2 diabetes
• ISSN: 1178-7007; 1178-7007
• DOI: 10.2147/DMSO.S447658

To evaluate the risk factors associated with diabetic macular edema (DME) in patients with a recent type 2 diabetes mellitus (T2DM) diagnosis. We conducted a case-control study at a third-level hospital in Mexico City. We enrolled patients ≥18 years old, with T2DM less than five years of diagnosis, without disabling complications, and non-smokers. The control group was patients with diabetic retinopathy and without macular edema (DR-DME). Cases were patients with DR+DME. We measured fasting glucose, creatinine, lipid profile, urinary albumin/creatinine ratio (ACR), and HbA1c. An ophthalmological examination consisted of visual acuity measurement, digital three-field fundus photography with an automatic non-mydriatic camera, slit lamp, and Optical coherence tomography (OCT) examination. 183 and 61 patients with DR-DME and DR+DME, respectively, were included in the analysis. The prevalence of mild DR was higher in the DR-DME group, but the frequencies of moderate and severe retinopathy were higher in the DR+DME group. Patients in the DR-DME group had better vision than those in the DR+DME group. Logistic regression analysis revealed that age (OR, 1.07), HbA1c (OR, 1.19), and Albumin-to-Creatinine Ratio (ACR) > 30 mg/g (OR, 3.37) were associated with an increased possibility of DME compared to DR-DME. Our study provides insights into the association between risk factors and DME. We found a statistically strong association between HbA1c levels, age, and ACR. Patients with poor metabolic control should undergo an extensive medical examination to screen for DME, which may be related to the chronicity of DM and renal damage.