Five-Year Incidence of Proliferative Diabetic Retinopathy and Associated Risk Factors in a Nationwide Cohort of 201 945 Danish Patients with Diabetes

Dinesen, Sebastian; Stokholm, Lonny; Subhi, Yousif; Savarimuthu, Thiusius Rajeeth; Andersen, Nis; Andresen, J.; Bek, Toke; Hajari, Javad Nouri; Heegaard, Steffen; Højlund, Kurt; Laugesen, Caroline Schmidt; Kawasaki, Ryo; Möller, Sören; Schielke, Katja Christina; Thykjær, Anne Suhr; Pedersen, Frederik Nørregaard; Grauslund, Jakob

doi:10.1016/j.xops.2023.100291

Cited by 9 publications

(6 citation statements)

References 30 publications

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“…Therefore, in our study, the increasing severity of retinopathy was closely related to the increasing severity of diabetic nephropathy. Similar findings were reported in some studies in which 20.50% of patients with diabetes for less than 5 years had microalbuminuria, while in patients with diabetes for more than 15 years, 90% had microalbuminuria [23][24][25]. A multiple increase was also observed in the microvascular complication of retinopathy, which in patients with diabetes duration of less than 5 years amounted to 25.6%, whereas in patients with diabetes duration of more than 15 years, it resulted in a 100% diagnosis of retinopathy.…”

Section: Discussionsupporting

confidence: 90%

Correlation between diabetic nephropathy and diabetic retinopathy as a long term complications of diabetes mellitus

Dervišević,

Rebić,

Dervišević

2023

Acta Marisiensis - Seria Medica

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Background/aim: Diabetes mellitus is a metabolic disorder of multiple etiologies characterized by a lack of insulin, with a consequent disordered metabolism of glucose, fats, and proteins. A number of complications, such as diabetic nephropathy and retinopathy, may develop as a result of long-term diabetes. The aim of this study aimed to determine the correlation between diabetic nephropathy and diabetic retinopathy as long-term complications of diabetes mellitus. Materials and methods: Retrospective, descriptive, and analytical research was conducted at the department of Endocrinology, Clinical Center, University of Sarajevo. The study included 158 patients hospitalized in time between 1st of January and 31st of December 2012. Results: New-onset diabetes was found in 38%, and diabetes type 2 patients 132 (83.5%), female 105 (66.5%) while older than 60 years were 100 (63.3%). Upon discharge from hospital 83,7% of patients were discharged with glycemia <10 mmol / l. We found that 47,5% of patients had HbA1c> 10%. Reduced kidney function, different degrees of failure was at 66.5%. More than half (62.7%) patients had proteinuria as a sign of diabetic nephropathy. Diabetic retinopathy was diagnosed with different types in 54.4%. Conclusion: Diabetes leads to an increase in nitrogen compounds, and the development of diabetic nephropathy manifests as various degrees of renal insufficiency. The duration of diabetes and occurrence of diabetic retinopathy were significantly interrelated. The correlation between the degree of renal failure and changes in the ocular fundus has not been proven, but more severe renal insufficiency is associated with a higher incidence of diabetic retinopathy compared to patients with less impaired renal function.

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Section: Discussionsupporting

confidence: 90%

Correlation between diabetic nephropathy and diabetic retinopathy as a long term complications of diabetes mellitus

Dervišević,

Rebić,

Dervišević

2023

Acta Marisiensis - Seria Medica

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“…This is supported by the older Liverpool Diabetic Eye study, using data from 1991, which suggests three yearly intervals for people with type 2 diabetes and no retinopathy and two‐yearly intervals for people with type 1 diabetes and no baseline retinopathy would be safe (Younis, Broadbent, Harding, & Vora, 2003; Younis, Broadbent, Vora, & Harding, 2003). Furthermore, a recently published study using Danish national screening program data determined that 0.1% of those with no baseline DR progressed to PDR after five years of follow‐up, an incidence rate of 0.7 per 1000 person‐years, which increased with increasing severity of baseline DR (Dinesen et al., 2023).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of diabetic retinopathy screening intervals

Drinkwater,

Kalantary,

Turner

2023

Acta Ophthalmologica

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The current evidence on whether annual diabetic retinopathy (DR) screening intervals can be extended was reviewed. A systematic review protocol was followed (PROSPERO ID: CRD42022359590). Original longitudinal articles that specifically assessed DR screening intervals were in English and collected data after 2000 were included. Two reviewers independently conducted the search and reviewed the articles for quality and relevant information. The heterogeneity of the data meant that a meta‐analysis was not appropriate. Twelve publications were included. Studies were of good quality and many used data from DR screening programs. Studies fit into three categories; those that assessed specific DR screening intervals, those that determined optimal DR screening intervals and those that developed/assessed DR screening risk equations. For those with type 2 diabetes, extending screening intervals to 3‐ to 4‐yearly in those with no baseline DR appeared safe. DR risk equations considered clinical factors and allocated those at lower risk of DR progression screening intervals of up to five years. Those with baseline DR or type 1 diabetes appeared to have a higher risk of progression to STDR and needed more frequent screening. DR screening intervals can be extended to 3–5 yearly in certain circumstances. These include patients with type 2 diabetes and no current DR, and those who have optimal management of other risk factors such as glucose and blood pressure.

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“…The models include 52 eyes from case patients with subsequent incidence of PDR and 107 eyes from control patients. We matched the two groups on age, sex, baseline DR-level, type of diabetes and time from first to last screening, which we consider a strength since these are considered risk factors for PDR (Dinesen et al, 2023;Sabanayagam et al, 2019;Wong et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Retinal main vessel calibers and systemic markers for long‐term development of proliferative diabetic retinopathy

Dinesen,

Stokholm,

Subhi

et al. 2023

Acta Ophthalmologica

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PurposeTo evaluate if retinal vascular calibers and systemic risk factors in patients with no or minimal diabetic retinopathy (DR) can predict risk of long‐term progression to proliferative diabetic retinopathy (PDR).MethodsThis was a matched case–control study of patients with diabetes having no or minimal DR at baseline with (cases) or without (controls) subsequent development of PDR. We collected six‐field, 45‐degree retinal images, demographic and clinical data from the Funen Diabetes Database.ResultsWe included 52 eyes from 39 cases and 107 eyes from 89 controls matched on sex, age, type of diabetes, time from first to last screening episode and baseline DR level. Cases had higher HbA1c (73 vs. 55 mmoL/moL; p < 0.001), triglycerides (1.32 vs. 1.16 mmoL/L; p = 0.02) and longer duration of diabetes (19 vs. 14 years; p = 0.01), but the groups did not differ in calibers of retinal arterioles (229 vs. 227 μm; p = 0.49), venules (289 vs. 290 μm; p = 0.83) or the arterio‐to‐venule ratio (0.78 vs. 0.77; p = 0.86).In a multivariable logistic regression model with cluster robust standard error, HbA1c (OR 1.54 per 10 mmoL/moL; 95%‐CI: 1.15–2.07; p = 0.004), triglyceride (OR 1.39 per 1 mmoL/L; 95%‐CI: 1.03–1.86; p = 0.03) and duration of diabetes (OR 1.09 per year; 95%‐CI: 1.03–1.16; p = 0.003) were independent risk factors for PDR.ConclusionRetinal vascular calibers did not predict long‐term development of PDR in contrast to well‐established risk factors like HbA1c, triglyceride and duration of diabetes.

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Five-Year Incidence of Proliferative Diabetic Retinopathy and Associated Risk Factors in a Nationwide Cohort of 201 945 Danish Patients with Diabetes

Cited by 9 publications

References 30 publications

Correlation between diabetic nephropathy and diabetic retinopathy as a long term complications of diabetes mellitus

Correlation between diabetic nephropathy and diabetic retinopathy as a long term complications of diabetes mellitus

A systematic review of diabetic retinopathy screening intervals

Retinal main vessel calibers and systemic markers for long‐term development of proliferative diabetic retinopathy

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