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Diabetic retinopathy found in 8% of pre-diabetic patients
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Nearly 8% of people identified with “pre-diabetes” were classified as having diabetic retinopathy, a report from the American Diabetes Association said. In addition, diabetic retinopathy was seen in 12% of participants with type 2 diabetes, the association said in a press release.
The research involved participants in the Diabetes Prevention Program, which included 3,234 people with impaired glucose tolerance, or “pre-diabetes.” According to the association, this marks the first long-term study to evaluate retinopathy in a population “so carefully examined for the presence or development” of type 2 diabetes.
“These findings reinforce the recommendation that patients with newly diagnosed type 2 diabetes should be screened for retinopathy,” Emily Chew, MD, of the National Eye Institute, said in the release.
Earlier studies have been unable to determine when type 2 diabetes begins, retarding the efforts of researchers to identify when diabetic retinopathy begins, said Richard Hamman, MD, DrPH, of the University of Colorado School of Medicine and vice chairman of the Diabetes Prevention Program. This study “suggests that changes in the eye may be starting earlier and at a lower glucose level than we previously thought,” he said in the release.
“Although the retinopathy seen in the DPP participants was at a very early stage and did not affect vision, eye changes typical for diabetes were found in 8% of our study population before they developed diabetes,” Dr. Hamman said. The retinopathy results were based on a random sample of only 12% of participants in the Diabetes Prevention Program, all of whom had impaired glucose tolerance when the study began.
Those who did not develop diabetes during the study (302 participants) and 588 who did develop diabetes participated in the retinopathy arm of the study, the release stated. Fundus imaging showed participants with pre-diabetes and retinopathy typically had a smaller number of microaneurysms in the eye characteristic of early, mild retinopathy that is not yet linked to vision loss. Those who had developed diabetes in the previous 1 to 5 years had slightly more severe retinopathy. Higher average blood glucose levels and higher blood pressure were associated with the risk of developing retinopathy in patients with newly onset diabetes.
The NEI, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institutes of Health, the Centers for Disease Control and Prevention and the Indian Health Service funded the study.