Incidence of Diabetic Retinopathy in Individuals with Type 2 Diabetes: A Study Using Real-World Data

Area of Science:

• Ophthalmology
• Endocrinology
• Public Health

Background:

• Diabetic retinopathy (DR) is a leading cause of blindness in patients with type 2 diabetes (T2DM).
• Primary care settings are crucial for managing T2DM and monitoring for complications like DR.
• Understanding DR incidence and risk factors in real-world settings is essential for effective prevention strategies.

Purpose of the Study:

• To determine the incidence of diabetic retinopathy (DR) in type 2 diabetes (T2DM) patients in Catalonia, Spain.
• To identify key clinical risk factors associated with the development of DR in this population.
• To inform primary care strategies for DR prevention and early detection.

Main Methods:

• Retrospective cohort study utilizing the SIDIAP database.
• Inclusion of T2DM patients aged 30-90 years who underwent retinal screening between 2010 and 2015.
• Multivariable Cox regression analysis to assess risk factors including HbA1c, diabetes duration, and comorbidities.

Main Results:

• A cohort of 146,506 T2DM patients with a mean follow-up of 6.96 years was analyzed.
• The incidence rate of DR was 6.99 per 1000 person-years (4.7% of patients developed DR).
• High HbA1c (>10%), longer diabetes duration, male sex, ex-smoker status, macrovascular disease, and chronic kidney disease were significant DR risk factors. Obesity showed a protective effect (HR: 0.93).

Conclusions:

• The incidence of DR in T2DM patients in primary care in Catalonia is 6.99 per 1000 person-years.
• Suboptimal glycemic control (HbA1c >10%) and extended diabetes duration are critical modifiable risk factors for DR.
• Intensified management of glycemic control and regular retinal screenings in primary care are vital for preventing DR progression and reducing its burden.