Proliferative Diabetic Retinopathy in Young-Onset Type 1 Diabetes in Croatia: Risk Factors and a Predictive Economic...

Area of Science:

• Ophthalmology
• Endocrinology
• Health Economics

Background:

• Proliferative diabetic retinopathy (PDR) is a significant complication of type 1 diabetes (T1D).
• Limited statistical data exists on PDR risk factors in young-onset T1D in Croatia.
• The clinical and financial impact of national diabetic retinopathy (DR) screening requires evaluation.

Purpose of the Study:

• To identify statistical risk factors for PDR in young-onset T1D patients in Croatia.
• To develop a predictive health economic model for national DR screening.
• To assess the cost-effectiveness of implementing a national DR screening program.

Main Methods:

• A cross-sectional study analyzed 58 young-onset T1D patients (June 2020-June 2022).
• Patients were classified into PDR and non-PDR groups based on fundus exams and photos.
• Logistic regression analyzed clinical, demographic, and laboratory data; a health economic model was developed.

Main Results:

• PDR was present in 47% of patients.
• PDR risk factors included longer diabetes duration, poor glycemic control, onset before 18, and irregular eye exams (OR 30-fold).
• Annual screening (60% uptake) could prevent 1973 PDR cases and save €14.2 million per 10,000 patients.

Conclusions:

• Strict glycemic control and regular eye examinations are critical for PDR prevention in young T1D.
• Establishing a national DR screening program is cost-effective, particularly in resource-limited settings.
• Screening demonstrates cost-effectiveness even with moderate uptake or less frequent intervals.