Nearly 1 in 5 Have Retinopathy at Type 2 Diabetes Diagnosis

TOPLINE:

Nearly one-fifth of people in Sweden during 2015-2019 had diabetic retinopathy (DR) at the time of type 2 diabetes (T2D) diagnosis, indicating longstanding hyperglycaemia and suggesting the need for intensified screening for T2D in clinical practice.

The prevalence of DR was higher in men, those born outside of Sweden, and those with a history of stroke, kidney disease, and high systolic blood pressure (SBP).

METHODOLOGY:

• Data were analysed for 77,681 individuals from the Swedish National Diabetes Registry with a retinal photo

TAKEAWAY:

• Overall, 17.2% (n = 13,329) of individuals had DR at diagnosis of T2D.
• Risk factors for DR included:
  • Older age (odds ratio, 1.03 per 10-year increase; P = .004).
  • Men (1.10 vs women; P
  • Lower education (1.08 for primary vs college/university; P = .009).
  • Previous stroke (1.18; P = .001).
  • Acetylsalicylic acid treatment (1.14; P
  • Angiotensin-converting enzyme inhibitor treatment (1.12; P
  • Alpha blocker treatment (1.41; P
  • Being born in Asia (1.16; P P
  • Higher SBP (1.33 for ≥ 140 mmHg vs 110-119 mmHg; P
• In contrast, the risk for DR decreased with higher body mass index vs 18.5-24.9 kg/m² (odds ratio of 0.75 for 30-34.9 and 0.72 for ≥ 35; both P
• There was no association between smoking and DR (1.05; P = .17).

IN PRACTICE:

“Further research is needed to develop efficient strategies and programs to not only screen for T2D at random in clinical practice but also more structured screening to detect T2D earlier. This is of particular concern since many persons may have hyperglycemia before diagnosis and are not targets of efficient prevention strategies for complications before diagnosis,” the authors wrote.

“Since a large proportion of persons with T2D in Sweden reach HbA1c targets, indicating high overall quality of diabetes care compared with many other countries, similar challenges in terms of detecting persons with T2D at an early stage of hyperglycemia seem likely in other European countries and parts of the world,” they added.

SOURCE:

The study was conducted by Sheyda Sofizadeh, of the Department of Medicine, NU- Hospital Group, Uddevalla, Sweden, and colleagues and published online on June 4, 2024, in BMJ Open Diabetes Research & Care.

LIMITATIONS:

No registry data were available on retinopathy of

DISCLOSURES:

The study was funded by the Swedish state under an agreement between the Swedish government and the county councils, the ALF-agreement, and the Fyrbodal Research Council. Sheyda Sofizadeh has been a consultant for AstraZeneca, Boehringer-Ingelheim, Novo Nordisk, and Sanofi. Some co-authors also have industry disclosures.