The Association of Diabetes Mellitus with Uveitis: A Real-World Data Analysis

Abstract

Purpose: To evaluate the association between type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM) with the incidence of uveitis. Methods: This was a retrospective cohort study utilizing the TriNetX Global Collaborative Network. Anonymized participants were patients diagnosed with T2DM or T1DM, including both insulin users and non-insulin users among those with T2DM, with and without diabetic retinopathy (DR). To ensure comparability between cohorts, we employed 1:1 propensity score matching, adjusting for demographic variables and relevant medical conditions. Results: At 1 year, the risk of uveitis was higher in patients with T2DM with or without DR compared to the control group (adjusted hazard ratio [HR] of 6.054; 95% CI: 5.484–6.683 and 1.381; 95% CI: 1.254–1.521); this risk remained high at 5 and 10 years. In T1DM patients with retinopathy, the HR increased compared to the control group from years 1 to 10 (HR at 1 year: 2.274; 95% CI: 1.137–4.547). Additionally, patients with T2DM and non-proliferative diabetic retinopathy (NPDR) had a reduced risk of uveitis compared to those with T2DM and proliferative diabetic retinopathy (PDR) at years 1–10 (HR at 1 year: 0.339; 95% CI: 0.302–0.380). Conclusion: Patients with T2DM are at a higher risk of developing uveitis compared to healthy individuals. This risk is further increased with coexisting DR and advancing stages of DR. T1DM patients with DR are also at an increased risk for uveitis. These findings emphasize the critical need for vigilant monitoring and targeted interventions to manage ocular health complications in diabetic populations.