1. Systemic and ocular outcomes in patients with young-onset type 2 diabetes.
- Author
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Au A, Bajar BT, Wong BM, Daskivich LP, Hosseini H, and Prasad PS
- Subjects
- Humans, Adult, Retrospective Studies, Eye, Risk Factors, Diabetic Retinopathy diagnosis, Diabetic Retinopathy epidemiology, Diabetic Retinopathy drug therapy, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 therapy
- Abstract
Purpose: To analyze the systemic and ocular outcomes in patients with young-onset type 2 diabetes (YO-DM2) based on grade of presenting diabetic retinopathy (DR)., Methods: Retrospective cohort study analysis of empaneled patients with type 2 diabetes <40 years old with retinopathy screening within the Los Angeles Department of Health Services between 01/01/2017-07/01/2021 were included. Patients were stratified based on presenting severity of DR determined on fundus photographs or clinical examination. Patient's systemic co-morbidities and ocular outcomes were then compared across each group. Procedural (e.g. intravitreal injections) and surgical interventions (e.g. pars plana vitrectomy) were documented as performed by the treating physician., Results: 2795 patients were screened from 12,456 patients diagnosed with diabetes younger than age 40 (22.4 %). Of these, 1496 patients were diagnosed with type 2 DM. 1084 (72.4 %) of patients presented without DR, 307 (20.5 %) presented with non-proliferative diabetic retinopathy (NPDR), and 105 (7.0 %) of patients presented with proliferative diabetic retinopathy (PDR). Increasing presenting diabetic retinopathy severity was associated with longer duration of diabetes, greater systemic comorbidities (e.g. diabetic foot disease, neuropathy, chronic kidney or end stage renal disease), worse baseline and final visual acuity, and required more procedural and surgical interventions., Conclusions: Worse presenting DR severity in patients young-onset type 2 diabetes was associated with greater comorbid systemic and ocular disease with worse visual acuity outcomes. <1 % of patients without diabetic retinopathy or with mild NPDR were likely to progress to PDR. Diabetic kidney disease was an independent risk factor for developing neovascular glaucoma and retinal detachments. Prompt evaluation and intervention in patients with YO-DM2 may help reduce the associated systemic and ocular morbidity., Competing Interests: Declaration of competing interest Pradeep Prasad has the following financial disclosures: Abbvie: C; Alimera Sciences, Inc.: C; DORC International, bv/Dutch Ophthalmic, USA: L; OD-OS GmbH: L; Regeneron Pharmaceuticals, Inc.: L. C=Consultant, L=Speaker/Lecturer. The other authors have no financial disclosures., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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