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Incidence of Proliferative Diabetic Retinopathy and Other Neovascular Sequelae at 5 Years Following Diagnosis of Type 2 Diabetes

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posted on 02.09.2021, 19:15 authored by William S. Gange, Khristina Lung, Jennifer Lopez, Benjamin Y. Xu, Seth A. Seabury, Brian C. Toy
Objective: To determine the incidence and risk factors for developing proliferative diabetic retinopathy (PDR), tractional retinal detachment (TRD), and neovascular glaucoma (NVG) at 5 years after initial diagnosis of type 2 diabetes.

Research Design and Methods: Insured patients age 18 or older with newly-diagnosed type 2 diabetes and 5 years of continuous enrollment were identified from a nationwide commercial claims database containing data from 2007-2015. The incidences of PDR, TRD, and NVG were computed at 5 years following index diagnosis of type 2 diabetes. Associations between these outcomes and demographic, socioeconomic, and medical factors were tested with multivariable logistic regression.

Results: At 5 years following initial diagnosis of type 2 diabetes, 1.74% (1,249/71,817) of patients had developed PDR. Additionally, 0.25% of patients had developed TRD, and 0.14% of patients had developed NVG. Insulin use (OR 3.59, 95% CI 3.16-4.08), maximum HbA1c >9% or 75mmol/mol (OR 2.10, 95% CI 1.54-2.69), renal disease (OR 2.68, 95% CI 2.09-3.42), peripheral circulatory disorders (OR 1.88, 95% CI 1.25-2.83), neurological disease (OR 1.62, 95% CI 1.24-2.11), and older age at diagnosis (age 65-74, OR 1.62, 1.28-2.03) were identified as risk factors for development of PDR at 5 years. Young age at diagnosis (age 18-34, OR 0.46, 95% CI 0.29-0.74), Medicare insurance (OR 0.60, 95% CI 0.70-0.76), morbid obesity (OR 0.72, 95% CI 0.59-0.87), and smoking (OR 0.84, 95% CI 0.70-1.00) were identified as protective factors.

Conclusions: A subset of patients with type 2 diabetes develop PDR and other neovascular sequelae within the first 5 years following diagnosis with type 2 diabetes. These patients may benefit from increased efforts for screening and early intervention.


This study was supported by NIH Grant P30EY029220 and an unrestricted departmental award from Research to Prevent Blindness, New York, NY. The sponsor or funding organizations had no role in the design or conduct of this research.