Incidence of Diabetic Retinopathy in Individuals with Type 2 Diabetes: A Study Using Real-World Data
Por:
Hernández-Teixidó, C, de la Puente, JB, Jiménez, SM, Fernández-Camins, B, Mauricio, D, Aroca, PR, Vlacho, B, Franch-Nadal, J
Publicada:
1 dic 2024
Resumen:
Background/Objectives: This study aimed to assess the incidence of diabetic retinopathy (DR) in patients with type 2 diabetes (T2DM) treated in primary-care settings in Catalonia, Spain, and identify key risk factors associated with DR development. Methods: A retrospective cohort study was conducted using the SIDIAP (System for Research and Development in Primary Care) database. Patients aged 30-90 with T2DM who underwent retinal screening between 2010 and 2015 were included. Multivariable Cox regression analysis was used to assess the impact of clinical variables, including HbA1c levels, diabetes duration, and comorbidities, on DR incidence. Results: This study included 146,506 patients, with a mean follow-up time of 6.96 years. During this period, 4.7% of the patients developed DR, resulting in an incidence rate of 6.99 per 1000 person-years. Higher HbA1c levels were strongly associated with an increased DR risk, with patients with HbA1c > 10% having more than four times the risk compared to those with HbA1c levels < 7% (hazard ratio: 4.23; 95% CI: 3.90-4.58). Other significant risk factors for DR included greater diabetes duration, male sex, ex-smoker status, macrovascular disease, and chronic kidney disease. In contrast, obesity appeared to be a protective factor against DR, with an HR of 0.93 (95% CI: 0.89-0.98). Conclusions: In our real-world setting, the incidence rate of DR was 6.99 per 1000 person-years. Poor glycemic control, especially HbA1c > 10%, and prolonged diabetes duration were key risk factors. Effective management of these factors is crucial in preventing DR progression. Regular retinal screenings in primary care play a vital role in early detection and reducing the DR burden for T2DM patients.
Filiaciones:
Hernández-Teixidó, C:
Primary Hlth Care Ctr Burguillos Cerro, Serv Extremeno Salud, Badajoz 06370, Spain
RedGDPS Fdn, Sabadell 08204, Spain
Univ Barcelona, Dept Med, Barcelona 08036, Spain
Fdn Inst Univ Recerca Atencio Primaria Salut Jordi, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona 08007, Spain
de la Puente, JB:
RedGDPS Fdn, Sabadell 08204, Spain
Fdn Inst Univ Recerca Atencio Primaria Salut Jordi, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona 08007, Spain
Inst Catala Salut, Primary Hlth Care Ctr Dr Jordi Nadal & Fabregas Sa, Primary Hlth Care Ctr Igualada Nord, Barcelona 08700, Spain
Jiménez, SM:
RedGDPS Fdn, Sabadell 08204, Spain
Inst Catala Salut, Primary Hlth Care Ctr Martorell, Gerencia Atencio Primaria Baix Llobregat, Barcelona 08007, Spain
Fernández-Camins, B:
RedGDPS Fdn, Sabadell 08204, Spain
Fdn Inst Univ Recerca Atencio Primaria Salut Jordi, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona 08007, Spain
Inst Recerca Hosp Sant Creu i Sant Pau, Barcelona 08041, Spain
Mauricio, D:
Hosp Santa Creu i Sant Pau, Dept Pathol, Barcelona 08025, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, ID CB15, Madrid 28029, Spain
Univ Vic, Cent Univ Catalonia, Dept Med, Vic 08500, Spain
Aroca, PR:
Univ Hosp Sant Joan, IISPV, Reus, Spain
Univ Rovira & Virgili, Inst Invest Sanitaria Pere Virgili IISPV, Tarragona 43002, Spain
Vlacho, B:
Fdn Inst Univ Recerca Atencio Primaria Salut Jordi, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona 08007, Spain
Inst Recerca Hosp Sant Creu i Sant Pau, Barcelona 08041, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, ID CB15, Madrid 28029, Spain
Franch-Nadal, J:
RedGDPS Fdn, Sabadell 08204, Spain
Univ Barcelona, Dept Med, Barcelona 08036, Spain
Fdn Inst Univ Recerca Atencio Primaria Salut Jordi, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona 08007, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, ID CB15, Madrid 28029, Spain
Inst Catala Salut, Primary Hlth Care Ctr Raval Sud, Gerencia Ambit Atencio Primaria Barcelona Ciutat, Barcelona 08007, Spain
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