Risk factors for diabetic retinopathy in Kuwaiti type 2 diabetic patients

To determine the risk factors associated with diabetic retinopathy in Kuwaiti subjects with type 2 diabetes.

Kuwaiti subjects with type 2 diabetes (n=165) attending the Diabetic Clinic at Al-Sabah Hospital, Kuwait between October 2000 and March 2005 were screened for diabetic retinopathy.

Any diabetic retinopathy was found in 40% while 20.6% had sight threatening retinopathy. Mild NPDR was present in 21.2%, moderate to severe non-proliferative diabetic retinopathy (NPDR) in 7.9%, and proliferative diabetic retinopathy (PDR) in 3.0%. Maculopathy was present in 10.3% and 7.9% of the patients were photocoagulated. Compared to those without retinopathy, diabetic patients with any retinopathy were significantly older (51.7 +/- 10.3 versus 47.2 +/- 9.5 years; p<0.005), had longer duration of diabetes (13.1 +/- 6.3 versus 4.7 +/- 5.4 years; p<0.0001), higher systolic blood pressure (142.9 +/- 23.0 versus 130.3 +/- 20.2; p<0.0001) and poor glycemic control (Hemoglobin A1c = 10.1 +/- 2.4 versus 8.9 +/- 2.3; p<0.005). The prevalence of hypertension and nephropathy was significantly higher in patients with any retinopathy than those without retinopathy (70.8% versus 49.5%; p<0.01 and 64.4% versus 30.8%; p<0.0001) respectively. Longer duration of diabetes and presence of nephropathy was the most significant independent factors associated with any retinopathy and sight-threatening retinopathy. Treatment with sulphonylurea or insulin, and poor glycemic control were other significant independent factors associated with any retinopathy.

Longer duration of diabetes, presence of nephropathy, glycemic control and mode of treatment were the most significant independent risk factors of diabetic retinopathy. However, a population-based study is warranted to identify the risk factors, as well as the prevalence of diabetic retinopathy.