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Risk factors for prevalent diabetic retinopathy and proliferative diabetic retinopathy in type 1 diabetes

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Abstract

Purpose

Age at diagnosis of type 1 diabetes (DM1) has been implied as an important factor associated with the development of the microvascular complications. Our aim was to identify factors associated with prevalent diabetic retinopathy (DR) and proliferative diabetic retinopathy (PDR) in DM1 people with early and late-onset.

Methods

We reviewed medical records from all DM1 people from the reference area of a tertiary center (about 340,000 persons). Univariate and multivariate logistic regression were used to assess the relationship between potential risk factors (sociodemographic, diabetes-related, co-morbidities, and laboratory parameters) and prevalent DR/PDR. We performed an analysis comparing patients diagnosed before (early-onset) and after (late-onset) 18 years of age.

Results

We included 140 patients in early-onset DM1 group and 169 in late-onset DM1 group. Longer duration of diabetes and HbA1c remained associated with prevalent DR in both groups after adjusting for potential risk factors. Nephropathy was associated with prevalent DR in the late-onset group but not in the early-onset group. Peripheral neuropathy remained associated with prevalent PDR when modeled together in the multivariate model. High BMI demonstrated a significative association with PDR in early but not in the late-onset DM1 group.

Conclusions

Although previous reports suggest that age at DM1 diagnosis may have a role in DR prevalence, the risk factors for DR in early and late-onset DM1 were similar for both groups. Duration of disease and lifelong metabolic control were the major predictors for DR in both groups. Nephropathy was associated with DR in patients with late-onset disease. Neuropathy was associated with PDR occurrence in both groups. BMI was associated with PDR early-onset DM1 group.

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Author notes

  1. These authors contributed equally: Rita Laiginhas, Carolina Madeira

Authors and Affiliations

  1. Faculty of Medicine, Porto University, Porto, Portugal

    Rita Laiginhas, Miguel Lopes & Margarida Barbosa

  2. Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal

    Rita Laiginhas

  3. Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal

    Carolina Madeira, Vitor Rosas, Fernando Falcão-Reis & Manuel Falcão

  4. Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João, Porto, Portugal

    João Sérgio Neves & Davide Carvalho

  5. Department of Surgery and Physiology, Faculty of Medicine of Porto University, Porto, Portugal

    João Sérgio Neves, Fernando Falcão-Reis & Manuel Falcão

  6. Department of Anesthesiology, Centro Hospitalar de São João, Porto, Portugal

    Margarida Barbosa

  7. I3S Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal

    Margarida Barbosa

  8. Department of Endocrinology, Diabetes and Metabolism, Faculty of Medicine of Porto University, Porto, Portugal

    Davide Carvalho

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  1. Rita Laiginhas
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Correspondence to Manuel Falcão.

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Laiginhas, R., Madeira, C., Lopes, M. et al. Risk factors for prevalent diabetic retinopathy and proliferative diabetic retinopathy in type 1 diabetes. Endocrine 66, 201–209 (2019). https://doi.org/10.1007/s12020-019-02047-z

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  • DOI: https://doi.org/10.1007/s12020-019-02047-z

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