Diabetic retinopathy in patients with long-standing type 1 diabetes—prevalence, severity and relationship with some modifiable and unmodifiable risk factors
DOI:
https://doi.org/10.14748/zn4svy83Keywords:
risk factors, diabetic retinopathy, type one diabetesAbstract
Introduction: Despite continuous progress in the treatment of type 1 diabetes mellitus (T1DM), diabetic retinopathy (DR) remains among the leading causes of blindness worldwide. Its usually asymptomatic course in the early stages contributes to late diagnosis.
Aim: The aim of this article is to assess the prevalence and severity of DR among a Bulgarian cohort with long duration of T1DM, as well as the relationship between DR and some modifiable and non-modifiable risk factors (RFs).
Materials and Methods: A total of 85 patients with T1DM with a duration of ≥ 14 years and 47 healthy controls, matched by age and body mass index, who participated in the scientific project Cardiovascular and Metabolic Risk Associated with Visceral Adipose Tissue in Patients with Type 1 Diabetes Mellitus completed in 2021, were included. All subjects underwent some anthropometric and laboratory tests, and participants with diabetes were screened for DR using a portable fundus camera.
Results: Diabetic retinopathy was detected in 75.3% (n = 64) of individuals with T1DM. The mean current glycated hemoglobin (HbA1c) level was 8.12%, and the median duration of diabetes was 27 years (IQR, 22–34). A total of 28.2% (n = 24) of patients were diagnosed with sight-threatening DR (STDR). The conducted analyses indicated that HbA1c was the most significant determinant of the presence of DR. Multiple logistic regression assessed the duration of DM and diabetic nephropathy as factors independently associated with STDR.
Conclusion: We found a high frequency of DR among the studied cohort and confirmed the significant role of HbA1c as an RF for concomitant DR. In addition to diabetes duration and renal parameters, the severity of DR was also associated with active smoking and the use of antihypertensive medications.
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