Prevalence and risk factors for diabetic retinopathy at diagnosis (DRAD) in patients recently diagnosed with type 2 diabetes (T2D) or latent autoimmune diabetes in the adult (LADA)

Martinell, Mats; Dorkhan, Mozhgan; Stålhammar, Jan; Storm, Petter; Groop, Leif; Gustavsson, Carin

Prevalence and risk factors for diabetic retinopathy at diagnosis (DRAD) in patients recently diagnosed with type 2 diabetes (T2D) or latent autoimmune diabetes in the adult (LADA)

Mark

Martinell, Mats ; Dorkhan, Mozhgan ^LU ; Stålhammar, Jan ; Storm, Petter ^LU

; Groop, Leif ^LU and Gustavsson, Carin ^LU (2016) In Journal of Diabetes and its Complications 30(8). p.1456-1461

Abstract: Purpose To study prevalence of diabetic retinopathy (DR) at diagnosis (DRAD) and to estimate contributing risk by sociodemographic, cardiovascular and metabolic characteristics present in patients recently diagnosed with type 2 diabetes (T2D) or latent autoimmune diabetes in the adult (LADA). Methods Patients (n = 2174) recently diagnosed T2D (93%) or LADA (7%) were included upon arrival for their baseline DR screening. Fundus photographs of 4902 eyes were graded by a senior ophthalmologist according to the International Diabetic Retinopathy Disease Severity Scale. Official registers held by Statistics Sweden provided sociodemographic variables. The National Patient Register and Swedish Prescribed Drug Register were used to assess... (More); Purpose To study prevalence of diabetic retinopathy (DR) at diagnosis (DRAD) and to estimate contributing risk by sociodemographic, cardiovascular and metabolic characteristics present in patients recently diagnosed with type 2 diabetes (T2D) or latent autoimmune diabetes in the adult (LADA). Methods Patients (n = 2174) recently diagnosed T2D (93%) or LADA (7%) were included upon arrival for their baseline DR screening. Fundus photographs of 4902 eyes were graded by a senior ophthalmologist according to the International Diabetic Retinopathy Disease Severity Scale. Official registers held by Statistics Sweden provided sociodemographic variables. The National Patient Register and Swedish Prescribed Drug Register were used to assess cardiovascular risk. Beta cell function (HOMA2%b) and insulin sensitivity (HOMA2%s) were estimated from fasting (f) C-Peptide using the homeostasis model assessment (HOMA) 2 calculator. Odds ratios (OR) for DRAD were estimated using generalized estimating equation models. Results The prevalence of DRAD was 12% (7% mild and 5% moderate) and of diabetic macular edema it was 11% (all within vascular arch). The prevalence did not significantly differ between T2D and LADA. Due to sample size, the regression analysis of LADA patients did not yield any significant estimates. In T2D low educational level (≤ 9 years) increased risk for DRAD by 44% (OR 1.44; 95% CI 1.07–1.93) and < 50% beta-cell function adjusted for HbA1c and insulin sensitivity at diagnosis increased the risk by 77% (OR 1.77; 95% CI 1.28–2.44). For every unit increase in BMI, risk for DRAD decreased by 3% (OR 0.97; 95% CI 0.95–0.99). Conclusions DRAD prevalence in patients recently diagnosed with T2D or is 12%. Low educational level and low beta cell function at diagnosis are risk factors for DRAD. Estimation of beta cell function from (f)C-Peptide and (f)P-Glucose may be a valuable tool in identifying patients at risk for DRAD.
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Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/d7a46050-c546-498f-a34a-988968c57650

author

Martinell, Mats ; Dorkhan, Mozhgan ^LU ; Stålhammar, Jan ; Storm, Petter ^LU

; Groop, Leif ^LU and Gustavsson, Carin ^LU

organization

publishing date

2016-11-01

type

Contribution to journal

publication status

published

subject

Endocrinology and Diabetes

keywords

Diabetes, Diabetic macular edema, Diabetic retinopathy, Diabetic retinopathy at diagnosis (DRAD), Latent autoimmune diabetes in the adult (LADA), Type 2 diabetes (T2D), ANDIS, diabetics

in

Journal of Diabetes and its Complications

volume

30

issue

8

pages

6 pages

publisher

Elsevier

external identifiers

pmid:27593902
wos:000399434900009
scopus:84994144983

ISSN

1056-8727

DOI

10.1016/j.jdiacomp.2016.08.009

language

English

LU publication?

yes

id

d7a46050-c546-498f-a34a-988968c57650

date added to LUP

2016-11-21 09:17:59

date last changed

2024-06-14 18:09:19

@article{d7a46050-c546-498f-a34a-988968c57650,
  abstract     = {{<p>Purpose To study prevalence of diabetic retinopathy (DR) at diagnosis (DRAD) and to estimate contributing risk by sociodemographic, cardiovascular and metabolic characteristics present in patients recently diagnosed with type 2 diabetes (T2D) or latent autoimmune diabetes in the adult (LADA). Methods Patients (n = 2174) recently diagnosed T2D (93%) or LADA (7%) were included upon arrival for their baseline DR screening. Fundus photographs of 4902 eyes were graded by a senior ophthalmologist according to the International Diabetic Retinopathy Disease Severity Scale. Official registers held by Statistics Sweden provided sociodemographic variables. The National Patient Register and Swedish Prescribed Drug Register were used to assess cardiovascular risk. Beta cell function (HOMA2%b) and insulin sensitivity (HOMA2%s) were estimated from fasting (f) C-Peptide using the homeostasis model assessment (HOMA) 2 calculator. Odds ratios (OR) for DRAD were estimated using generalized estimating equation models. Results The prevalence of DRAD was 12% (7% mild and 5% moderate) and of diabetic macular edema it was 11% (all within vascular arch). The prevalence did not significantly differ between T2D and LADA. Due to sample size, the regression analysis of LADA patients did not yield any significant estimates. In T2D low educational level (≤ 9 years) increased risk for DRAD by 44% (OR 1.44; 95% CI 1.07–1.93) and &lt; 50% beta-cell function adjusted for HbA1c and insulin sensitivity at diagnosis increased the risk by 77% (OR 1.77; 95% CI 1.28–2.44). For every unit increase in BMI, risk for DRAD decreased by 3% (OR 0.97; 95% CI 0.95–0.99). Conclusions DRAD prevalence in patients recently diagnosed with T2D or is 12%. Low educational level and low beta cell function at diagnosis are risk factors for DRAD. Estimation of beta cell function from (f)C-Peptide and (f)P-Glucose may be a valuable tool in identifying patients at risk for DRAD.</p>}},
  author       = {{Martinell, Mats and Dorkhan, Mozhgan and Stålhammar, Jan and Storm, Petter and Groop, Leif and Gustavsson, Carin}},
  issn         = {{1056-8727}},
  keywords     = {{Diabetes; Diabetic macular edema; Diabetic retinopathy; Diabetic retinopathy at diagnosis (DRAD); Latent autoimmune diabetes in the adult (LADA); Type 2 diabetes (T2D); ANDIS; diabetics}},
  language     = {{eng}},
  month        = {{11}},
  number       = {{8}},
  pages        = {{1456--1461}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Diabetes and its Complications}},
  title        = {{Prevalence and risk factors for diabetic retinopathy at diagnosis (DRAD) in patients recently diagnosed with type 2 diabetes (T2D) or latent autoimmune diabetes in the adult (LADA)}},
  url          = {{http://dx.doi.org/10.1016/j.jdiacomp.2016.08.009}},
  doi          = {{10.1016/j.jdiacomp.2016.08.009}},
  volume       = {{30}},
  year         = {{2016}},
}

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Prevalence and risk factors for diabetic retinopathy at diagnosis (DRAD) in patients recently diagnosed with type 2 diabetes (T2D) or latent autoimmune diabetes in the adult (LADA)