Purpose

Despite progress in type 1 diabetes (T1DM) therapy, diabetic retinopathy (DR) is still a common complication. We analysed predictors and prevalence of DR in patients with T1DM lasting 10 years or more. All of the patients were considered to be currently in excellent glycemic control and treated using modern therapies.

Methods

Study included 384 (80.7% women) T1DM patients participating in the Program of Comprehensive Outpatient Specialist Care at the University Hospital in Krakow between the years 2014 and 2020. A retrospective analysis of medical records was conducted.

Results

The patients were on average 34 ± 9.2 years old, had a BMI 25.0 ± 3.9 and a T1DM duration of 20.5 ± 7.9 years. The mean level of HbA1c throughout the follow-up (mean duration 4.9 ± 1.4 years) was 6.9 ± 1%. The group included 238 (62.0%) patients treated with insulin pumps and 99 (25.8%) on multiple daily injections, 47 (12.2%) used both methods; almost all patients were on insulin analogues. DR was confirmed in 150 (39.1%) patients, from which 109 (28.4%) were diagnosed de novo. Severe DR was occurred in just 31 cases (8.1%). In the multivariate logistic regression, independent risk factors for the presence of DR were T1DM duration (OR 1.13; 95% CI, 1.09–1.19), HbA1c level (OR 1.41; 95% CI, 1.08–1.84), LDL level (OR 1.79; 95% CI, 1.16–2.87), and the combined presence of non-DR micro- and macrovascular chronic complications (OR 1.86; 95% CI, 1.16–3.03).

Conclusions

In this highly-selected group of T1DM patients, mostly female, the prevalence of both DR at any stage and severe DR was lower than earlier reported results from other cohorts. Independent risk factors for the DR cohort did not differ from previously reported studies.

中文翻译：

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长期 1 型糖尿病且目前血糖控制良好的患者糖尿病视网膜病变患病率低——单中心回顾性评估

目的

尽管 1 型糖尿病 (T1DM) 治疗取得了进展，但糖尿病视网膜病变 (DR) 仍然是一种常见的并发症。我们分析了持续 10 年或更长时间的 T1DM 患者 DR 的预测因素和患病率。所有患者都被认为目前血糖控制良好，并使用现代疗法进行治疗。

方法

研究纳入了 2014 年至 2020 年间在克拉科夫大学医院参加综合门诊专科护理计划的 384 名（80.7% 为女性）T1DM 患者。对医疗记录进行了回顾性分析。

结果

患者平均年龄为 34 ± 9.2 岁，BMI 为 25.0 ± 3.9，T1DM 病程为 20.5 ± 7.9 年。整个随访期间（平均持续时间 4.9 ± 1.4 年）HbA1c 的平均水平为 6.9 ± 1%。该组包括 238 名 (62.0%) 接受胰岛素泵治疗的患者和 99 名 (25.8%) 接受每日多次注射的患者，其中 47 名 (12.2%) 使用两种方法；几乎所有患者都在服用胰岛素类似物。150 名 (39.1%) 患者确诊为 DR，其中 109 名 (28.4%) 为新诊断。仅 31 例 (8.1%) 发生严重 DR。在多变量逻辑回归中，出现 DR 的独立危险因素是 T1DM 持续时间（OR 1.13；95% CI，1.09-1.19）、HbA1c 水平（OR 1.41；95% CI，1.08-1.84）、LDL 水平（OR 1.79 ; 95% CI, 1.16–2.87), 以及非 DR 微血管和大血管慢性并发症的合并存在 (OR 1.86; 95% CI, 1.16–3.

结论

在这个经过高度选择的 T1DM 患者组中，大多数是女性，任何阶段的 DR 和严重 DR 的患病率都低于其他队列的早期报告结果。DR 队列的独立危险因素与之前报道的研究没有差异。