Current diabetes management reduces retinopathy risk, but prevalence still high

HELSINGBORG, Sweden — Strict glycemic control in diabetes reduces the risk for developing retinopathy. However, despite modern diabetes management, almost 40% of young adults diagnosed with diabetes will still develop retinopathy within the first 10 years after diagnosis. These are among the finding of a large cohort study of diabetic patients in Sweden.

The study authors note that while the prevalence of retinopathy was still high in the study, it is clearly lower than the prevalence of retinopathy after a similar duration of diabetes before strict glycemic control was advocated.

The Diabetes Incidence Study in Sweden, a national population-based cohort study, identified 806 people with diabetes who were between the ages of 15 and 34 in 1987-1988. Of those, 627 (78%) were followed up at 10 years to determine the incidence of retinopathy development. In most cases, the assessment was based on retinal photographs.

Ten years after initial diabetes diagnosis, retinopathy was found in 247 patients (39%). Mild retinopathy was diagnosed in 206 patients, 30 patients were diagnosed with moderate nonproliferative diabetic retinopathy and 11 patients had proliferative diabetic retinopathy.

Patients diagnosed with retinopathy had worse glycemic control of their diabetes during the years of the study than patients who did not develop retinopathy (P < .001). In a Cox regression analysis, retinopathy development was related to both high HbA1c (P < .001) and high body mass index (P = .001).

Patients with type 2 diabetes had an increased prevalence of severe retinopathy compared to patients with type 1 diabetes.

The study is published in the February issue of Diabetes Care.