Prevalence and risk factors for retinopathy in adolescents with type 1 diabetes

Abstract

Objectives To establish the prevalence of, and risk factors associated with, diabetic retinopathy in an Australian adolescent diabetes clinic population. Design A prospective longitudinal study; baseline findings. Patients Two hundred and fifty‐five patients with Type 1 (insulin‐dependent) diabetes mellitus assessed by our service were studied. Entry criteria were: age 11.0‐19.9 years; diabetes duration of at least two years; and gradable fundus photographs of at least one eye. Main outcome measures The presence and severity of retinopathy, as assessed by the grading of stereoscopic fundus photographs. Possible risk factors assessed were age, sex, diabetes duration, pubertal stage, blood pressure, glycaemic control and total cholesterol level. Results The prevalence of retinopathy was 42%; all of those affected had mild background retinopathy. Highly significant associations were found with glycaemic control and both total and prepubertal duration of diabetes. No associations were found with age, sex, pubertal stage, blood pressure or total cholesterol level. Conclusions The high prevalence of early diabetic retinopathy in this group of Australian adolescents is comparable to recent reports from other centres. The significant associations with glycaemic control and duration of diabetes provide further strong evidence for the benefit of optimal glycaemic control during adolescence. Our finding that the prepubertal years of diabetes contribute to the development of retinopathy suggests that glycaemic control before puberty should also be optimised. The planned follow‐up of this cohort will establish the risk of progression to vision‐threatening retinopathy and allow risk factors to be further evaluated.

Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review

“…The DR prevalence among the T1DM was reported to be lower in Asia with the lowest prevalence in India (13.4%), followed by China (14%) . In Australia and New Zealand, the DR prevalence rate ranged from 25% to 42% . The prevalence of DME is related to the disease duration, with low rates of DME within 5 years of T1DM diagnosis, increasing to 29% at 20 years .…”

The current status of visual disability in the elderly population of Taiwan

“…19 Early screening and appropriate intervention have been demonstrated to be very effective in reducing visual impairment and blindness attributed to retinopathy. 20 Because of a high prevalence of chronic diseases (such as diabetes mellitus) in the elderly population, we should pay more attention to renewed efforts for effective public health initiatives. Compared with other related eye diseases, age-related macular degeneration and corneal diseases had relatively lower prevalence among the elderly population in the present study.…”

Population-Based Study of Nonproliferative Diabetic Retinopathy Among Type 2 Diabetic Patients in Kinmen, Taiwan

“…4 Early screening and appropriate intervention have been shown to be very effective in reducing visual loss and blindness attributed to DR. 5 The United Kingdom Prospective Diabetes Study (UKPDS) also showed that careful ophthalmic assessment is important, since DR is common in newly diagnosed type 2 diabetic patients. 6 In addition, the duration of diabetes, [7][8][9][10][11][12][13] age at examination, 10,13 type of diabetes treatment, 14,15 blood pressure, 6,16 serum cholesterol, 7 and body mass index (BMI) 10 have been reported to be associated with DR among type 2 diabetic patients.…”