Factors that predict at an early stage the risk of diabetic retinopathy

This study investigated factors that might increase the risk of developing diabetic retinopathy (DR) in patients with type 1 diabetes (T1D). It was determined that older age at diagnosis, high HbA1c levels (measures average blood glucose over the last 3 months) 1 year after diagnosis, in addition to severe hypoglycemia (dangerously low blood glucose), and ketoacidosis (life-threatening emergency with high blood glucose), were associated with higher risk of developing DR at later stages.

DR is a common complication of T1D. In DR blood vessels in the retina (part of the eye) become damaged, may become leaky, and may increase in number. DR can lead to loss of vision or blindness.

Factors like HbA1c, blood pressure and abnormal levels of fat in the blood (dyslipidemia) have been linked to the development of DR. However, these factors tend to change over time. Factors that influence at an early stage the risk of DR are still under investigation.

This study used a French database to gather information on 712 adults with T1D. HbA1c, blood pressure, and fat in the blood were measured 1 year after diagnosis of T1D. Severe hypoglycemia and ketoacidosis occurring for the first time after diagnosis were noted.

28% of participants developed DR, after an average of 24 years. Patients with an elevated HbA1c level 1 year after diagnosis were 38% more likely to develop DR than those with normal HbA1c levels. Patients who experienced severe hypoglycemia were 3 times more likely to develop DR than patients who did not. Participants who experienced ketoacidosis were 96% more likely to develop DR than those who did not. Being older at the time of diagnosis of T1D was associated with a slightly higher risk of developing DR.

The study concluded that high HbA1c levels 1 year after diagnosis, severe hypoglycemia, ketoacidosis, and older age at diagnosis, were associated with a higher risk of developing DR.

Information about the participants was gathered from a database. The researchers did not interview or examine the patients. This means they could not check that all of the data was accurate.

Discuss your risks for DR with your physician.