Prevalence, incidence, and risk factors of diabetic retinopathy and macular edema in patients with early and late-onset type 2 diabetes mellitus

Abstract

Aims: To compare the prevalence, incidence, and factors of diabetic retinopathy (DR) and macular edema (DME) in patients with early-onset (EOD) and late-onset diabetes (LOD). Methods: Participants with type 2 diabetes mellitus (T2DM) were recruited from a community-based study conducted in southern urban China. Participants were followed up for 2 years. The prevalence and incidence of DR and DME were compared between EOD (≤40 years) and LOD (>40 years) groups, and potential factors were evaluated using multivariate logistic regression. Results: Among 2,703 participants, 173 (6.4%) with EOD had a higher prevalence of DR than 2,530 (93.6%) with LOD (27.8% vs 15.5%, P < 0.001). Participants with EOD had a higher incidence of DR, although this difference was not statistically significant (EOD: 8.1% vs LOD: 3.6%, P = 0.12). Insulin use and higher HbA1c levels were significantly associated with DR in both EOD and LOD groups (both P < 0.05). Additionally, longer diabetes duration, higher systolic blood pressure, and the presence of albuminuria independently associated with the presence of any DR in LOD patients (all P < 0.05). For DME, HbA1c level was a significant association in EOD, while in LOD, age, BMI, insulin use, and albuminuria were significant factors (all P < 0.05). Conclusions: A higher prevalence of DR was observed among patients with early-onset T2DM in urban southern China. Timely diagnosis of DR and regular eye care services are needed for early-onset T2DM.