Thirty-Year Time Trends in Diabetic Retinopathy and Macular Edema in Youth With Type 1 Diabetes

• DOI: 10.2337/figshare.19404050.v1
• Publication Date: 2022-05-20T15:33:43Z
• Authors: Digby W. Allen; Gerald Liew; Yoon Hi Cho; Alison Pryke; Janine Cusumano; Stephen Hing; Albert K Chan; Maria E. Craig; Kim C. Donaghue
• Keywords: Diabetic macular edema

<i>Objective:</i> To examine trends in diabetic retinopathy (DR) and macular edema (DME) adolescents with type 1 diabetes between 1990–2019. <p><i>Research Design Methods: </i>We analyzed 5,487 complication assessments 2,404 (52.7% female, aged 12–20 years, duration >5 years), stratified by three decades (1990–1999, 2000–2009, 2010–2019). DR DME were graded according to the modified Airlie House classification from seven-field stereoscopic fundal photography.</p> <p><i>Results: </i>Over decades, prevalence of was 40, 21, 20% respectively (p<0.001) 1.4, 0.5, 0.9% (p=0.13). Continuous subcutaneous insulin infusion (CSII) use increased (0, 12, 55%; p<0.001); mean HbA1c bimodal (8.7, 8.5, 8.7%; p<0.001) proportion meeting target HbA<sub>1c</sub> <7% did not change significantly (8.3, 7.7, 7.1%; p=0.63). In multivariable generalized estimating equation analysis, associated 1-2 daily injections (OR 1.88, 95% CI 1.42-2.48) multiple compared CSII (1.38, 1.10-1.74); older age (1.11, 1.07-1.15), higher (1.19, 1.05-1.15), longer (1.15, 1.12-1.18), overweight/obesity (1.27, 1.08-1.49) diastolic blood pressure SDS 1.01-1.21). (3.26, 1.72-6.19), (1.26, 1.12-1.41), (1.66, 1.22-2.27), (1.28, 1.03-1.59) elevated cholesterol (3.78, 1.84-7.76).</p> <i>Conclusions: </i>One five had last decade. These findings support contemporary guidelines for lower glycemic targets, increasing targeting modifiable risk factors including pressure, overweight/obesity. <br>