Aims

Identifying and modulating risk factors is essential to prevent visual impairment due to diabetic retinopathy (DR). This study examines incident DR with metabolic and hormonal factors in newly-diagnosed, treatment naïve, individuals with Type2 Diabetes Mellitus (T2DM), over a 5 year period from diagnosis.

Methods

233 T2DM subjects underwent serial DR screening using digital photography and standardised Meal Tolerance Tests at diagnosis and after 1, 2 and 5 years. Subjects (179) with no DR throughout the 5-year study period were compared with those who developed DR (54).

Results

Of 233 subjects, 54(23.2%) developed DR by 5 years, background DR in 50(93%) and exudative maculopathy in 4(7%) individuals. Of these subjects, 12(22%) developed DR after 1 year, 15(28%) after 2 years and 27(50%) after 5 years.

At baseline, those with DR at 5 years had higher HbA_1c (p = 0.017), higher fasting plasma glucose (PG) (p = 0.031) and postprandial PG (p = 0.009). They were associated with reduced basal β-cell secretory function (M₀) (p = 0.025), lower (p = 0.000) postprandial β-cell responsiveness (M₁) and β-cell function (HOMA-B) (p = 0.044).

Conclusions

There is an independent association between glycaemic control and β-cell dysfunction at the time of diagnosis of T2DM, with incident DR over a follow-up period of 5 years.

中文翻译：

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新诊断的 2 型糖尿病患者 5 年以上糖尿病视网膜病变的发病率：β 细胞功能的贡献

目标

识别和调节风险因素对于预防糖尿病视网膜病变 (DR) 引起的视力障碍至关重要。本研究检查了新诊断、未接受治疗的 2 型糖尿病 (T2DM) 患者在诊断后 5 年内发生的 DR 与代谢和激素因素的关系。

方法

233 名 T2DM 受试者在诊断时和 1、2 和 5 年后使用数码摄影和标准化膳食耐受测试进行了系列 DR 筛查。将在 5 年研究期间没有 DR 的受试者 (179) 与发生 DR 的受试者 (54) 进行比较。

结果

在 233 名受试者中，54 名（23.2%）在 5 年内发展为 DR，50 名（93%）为背景 DR，4 名（7%）为渗出性黄斑病变。在这些受试者中，12 人（22%）在 1 年后发展为 DR，15 人（28%）在 2 年后发展，27 人（50%）在 5 年后发展。

在基线时，5 年 DR 患者的 HbA _1c (p = 0.017)、空腹血糖 (PG) (p = 0.031) 和餐后 PG (p = 0.009) 较高。它们与降低的基础 β 细胞分泌功能 (M ₀ ) (p = 0.025)、降低 (p = 0.000) 餐后 β 细胞反应性 (M ₁ ) 和 β 细胞功能 (HOMA-B) (p = 0.044) 相关）。

结论

在诊断为 T2DM 时，血糖控制与 β 细胞功能障碍之间存在独立关联，在 5 年的随访期内发生 DR。