Prevalence and risk factors for diabetic retinopathy in Asian Indians with young onset Type 1 and Type 2 Diabetes

• Published in: Journal of diabetes and its complications 2014-05, Vol.28 (3), p.291-297
• Main Authors: Rajalakshmi, Ramachandran, Amutha, Anandakumar, Ranjani, Harish, Ali, Mohammed K, Unnikrishnan, Ranjit, Anjana, Ranjit Mohan, Narayan, K.M. Venkat, Mohan, Viswanathan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Age Factors; Asia - ethnology; Asian Indians; Blood Pressure - physiology; Body mass index; C-Peptide - blood; Child; Cholesterol; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - ethnology; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - ethnology; Diabetic retinopathy; Diabetic Retinopathy - blood; Diabetic Retinopathy - epidemiology; Diabetic Retinopathy - ethnology; Endocrinology & Metabolism; Female; Glucose; Glycated Hemoglobin A - metabolism; Humans; Hyperglycemia; India - epidemiology; Insulin; Lipoproteins; Logistic Models; Male; Peptides; Plasma; Prevalence; Retrospective Studies; Risk Factors; T1DM-Y; T2DM-Y; Triglycerides; Young Adult
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2013.12.008

Abstract Aim To assess the prevalence and risk factors for diabetic retinopathy (DR) in people with young onset type 1 (T1DM-Y) and type 2 diabetes (T2DM-Y). Methods T1DM-Y(n = 150) and T2DM-Y(n = 150) participants, age between 10 and 25 years at diagnosis, had a complete clinical evaluation, biochemical assessment, and four field digital retinal colour photography. The Early Treatment Diabetic Retinopathy Study grading system was used to grade DR. Proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) were considered as sight threatening DR. Results The prevalence of any DR was 53.3% [95% CI 45.3–61.3] in T1DM-Y (duration of diabetes: 12.4 ±7.4years) and 52.7% [44.7–60.7] in T2DM-Y (11.8 ± 8.3 years). The age and gender adjusted prevalence of DR, DME and PDR was 62.5%, 10% and 7.3% in T1DM-Y, whereas it was 65.8%,12.7% and 9.3% in T2DM-Y respectively. In multivariable logistic regression, diabetes duration [Odds ratio (OR) 1.99 per 5 years; CI 1.42–2.79], waist circumference [1.28 per 5 cm;1.05–1.56] and microalbuminuria [2.39 per 50 μg;1.07–5.31] were associated with DR in T1DM-Y, and diabetes duration [2.21 per 5 years; 1.61–3.02], diastolic blood pressure [1.54 per 5 mmHg;1.18–2.02], Glycated hemoglobin [1.37 per %;1.07–1.75] and lower stimulated C-peptide [1.54 per 0.5 pmol/ml;1.15–2.05;] were associated with DR in T2DM-Y. Conclusion Over half of the people with young-onset diabetes, regardless of type, have retinopathy within 10–12 years of diabetes duration, emphasizing the need for regular eye screening and aggressive control of glucose and blood pressure to prevent DR.