Association of mobile phone usage time with incidence of diabetic retinopathy in type 2 diabetes: a prospective cohort study

Abstract

We prospectively analyzed the association between mobile phone usage time and the incidence of diabetic retinopathy (DR) in type 2 diabetes (T2D) among participants.We included a total of 4,371 patients with T2D among the participants. Mobile phone usage time was quantified at baseline by summing up the hours spent on mobile phone use. The types of mobile phone usage time in our study include game time, TikTok time, WeChat time, watching movies or reading time, and online shopping time. We categorized patients into four groups according to different mobile phone usage time: ≤1.5 h/day (n = 1,101), 1.6–3.5 h/day (n = 1,098), 3.6–7.5 h/day (n = 1,095), and >7.6 h/day (n = 1,077). Fundus photography was performed every year from January 2012 to January 2020. During a follow-up of 8 years, 1,119 were affected by DR, resulting in an overall incidence of 25.6%. The incidences of mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR, and proliferative DR (PDR) were 10.1%, 5.1%, 5.1%, and 5.2%, respectively. In comparisons with participants in the lowest category (≤1.5 h/day), the hazard ratios (HRs) of DR were 1.19 (95% confidence interval [CI] 1.07, 1.31, p = 0.040) for 1.6–3.5 h/day, 1.60 (95% CI 1.40, 1.81, p < 0.001) for 3.6–7.5 h/day, and 1.85 (95% CI 1.61, 2.09, p < 0.001) for >7.6 h/day, respectively. Our results provide the general population with a feasible and practical alternative for the reduction of mobile phone use behavior time and new measures to prevent the occurrence of DR.