Prevalence of Diabetic Retinopathy Lower at Younger Age in Youth with T2D

Article

An analysis of 3 academic health centers suggests youth with diabetic retinopathy had a longer duration of diabetes and higher hemoglobin A1c at the time of the diabetic eye exam.

Roomasa Channa, MD | Credit: University of Wisconsin

Roomasa Channa, MD

Credit: University of Wisconsin

New results show youth with type 2 diabetes (T2D) with younger age and shorter duration of diabetes experience a lower prevalence of diabetic retinal disease, including diabetic retinopathy.1

The results, presented at the 83rd Scientific Sessions of the American Diabetes Association (ADA 2023), contrasted with the prevalence of diabetic retinal disease reported in youth from the Treatment Options for T2D in Adolescents and Youth (TODAY) study.

“Further work is needed to determine the inflection point when the incidence of diabetic retinal disease increases and the impact of newer medications on the occurrence of diabetic retinal disease,” wrote the investigative team, led by Roomasa Channa, MD, an assistant professor in the department of ophthalmology and visual sciences at the University of Wisconsin.

Diabetic retinal diseases are a microvascular complication of T2D and a major cause of global vision loss.2 In the TODAY study, the results showed a diabetic retinal disease prevalence of 51% among patients with youth-onset T2D (average T2D duration, 13.3 years; mean age, 26.4 years). However, Channa and colleagues suggest the prevalence of diabetic retinal disease in youth-onset T2D with shorter duration and younger age remains unknown.1

The current multicenter analysis examined eye exams or retinal images from patients with youth-onset T2D at Cincinnati Children’s, Johns Hopkins, and the University of Wisconsin for the presence of diabetic eye diseases. The investigative team used t-tests and Fisher’s exact tests to analyze the characteristics of the study population.

The analysis included 228 youth (mean age, 16.5 years; mean T2D duration, 3.0 years). Of this population, 7 participants (3%) were positive for diabetic retinopathy. When compared to youth without diabetic retinal disease (n = 221%), investigators found those with diabetic retinal disease had a longer duration of diabetes (5.3 years vs. 2.9 years; P = .015). In addition, those with diabetic retinal disease had a higher hemoglobin A1c at the time of the diabetic eye exam (10.0 vs. 7.5 years; P = .012).

Investigators indicated no difference in age, race, ethnicity, or sex between those with or without diabetic retinal disease. However, of those with diabetic retinal disease, non-Hispanic Black youth had a higher rate of positive diabetic retinal disease exams compared to youth of other races and ethnicities (6% vs. 0.8%; P = .045). The analysis further showed no significant difference in the presence or absence of diabetic retinal disease and the type of prescribed medication.

“Among youth with T2D, with younger age and shorter duration of diabetes compared to those in the TODAY study, the prevalence of diabetic retinal disease was low,” investigators wrote.

References

  1. Channa R, Shah AS, Shah VS, Bahrainian M, Brown EA, Liu TYA, Magella B, Lehmann H, Abramoff MD, Wolf RM. Multicenter analysis diabetic retinal disease in youth with Type 2 diabetes mellitus. Poster presentation at the 83rd Scientific Sessions of the American Diabetes Association. June 23 – 26, 2023.
  2. Saaddine JB, Honeycutt AA, Narayan KMV, Zhang X, Klein R, Boyle JP. Projection of Diabetic Retinopathy and Other Major Eye Diseases Among People With Diabetes Mellitus: United States, 2005-2050. Arch Ophthalmol. 2008;126(12):1740–1747. doi:10.1001/archopht.126.12.1740
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