Original articleIncidence and Risk Factors for Developing Diabetic Retinopathy among Youths with Type 1 or Type 2 Diabetes throughout the United States
Section snippets
Data Source
The Clinformatics Data Mart database (OptumInsight, Eden Prairie, MN), a data set that has been used previously to study ocular diseases,17, 18, 19 contains detailed records of beneficiaries in a large, nationwide managed-care network in the United States. We accessed data on all beneficiaries 21 years of age or younger at their initial enrollment during January 1, 2001, through December 31, 2014. Medical claims from inpatient and outpatient health care encounters and associated International
Patient Characteristics
Among the 2240 eligible youths with newly diagnosed T1DM and 1768 with newly diagnosed T2DM, the median age at DM onset in those with T1DM and T2DM were 12 and 18 years, respectively, and the median follow-up times after initial DM diagnosis were 3.2 and 3.1 years, respectively. The maximum follow-up time was 13.0 and 12.7 years for youths with T1DM and T2DM, respectively, resulting in a maximum age of 34 years at the end of follow-up. The majority of participants with T2DM were female (83.0%).
Discussion
In this study of youths in a large US managed-care network, >20% of youths with T1DM and 7% with T2DM, with a median of >3 years of follow-up, received a diagnosis of DR. Youth with T1DM had nearly a 3-fold-increased incidence and prevalence of DR compared with youths with T2DM. For each year older a child was at initial DM diagnosis, the risk for developing DR increased among those with T1DM. Higher household net worth and female sex seemed to be protective against DR among those with T2DM.
References (43)
- et al.
The global spread of type 2 diabetes mellitus in children and adolescents
J Pediatr
(2005) - et al.
Ocular complications in children with diabetes mellitus
Ophthalmology
(2015) - et al.
The relationship between components of metabolic syndrome and open-angle glaucoma
Ophthalmology
(2011) - et al.
Racial differences in age-related macular degeneration rates in the United States: a longitudinal analysis of a managed care network
Am J Ophthalmol
(2011) - et al.
Differences in rates of glaucoma among Asian Americans and other racial groups, and among various Asian ethnic groups
Ophthalmology
(2011) - et al.
Prevalence and risk factors for diabetic retinopathy in Asian Indians with young onset type 1 and type 2 diabetes
J Diabetes Complications
(2014) - et al.
Type 2 diabetes in younger adults: clinical characteristics, diabetes-related complications and management of risk factors
Prim Care Diabetes
(2011) - et al.
Trends in the incidence of childhood-onset diabetes in Europe 1989–1998
Diabetologia
(2001) - et al.
Incidence of and mortality from type I diabetes in Taiwan from 1999 through 2010: a nationwide cohort study
PLoS One
(2014) The rising tide of type 2 diabetes
Br J Diabetes Vasc Dis
(2001)
Type 2 diabetes in youth: epidemiology and pathophysiology
Diabetes Care
Early risk stratification in pediatric type 1 diabetes
Acta Ophthalmol
Diabetic retinopathy and its relevance to paediatric age. An update
Pediatr Endocrinol Rev
Prevalence of diabetic retinopathy within a national diabetic retinopathy screening service
Br J Ophthalmol
Systematic screening for diabetic retinopathy (DR) in Hong Kong: prevalence of DR and visual impairment among diabetic population
Br J Ophthalmol
Screening for retinopathy in the pediatric patient with type 1 diabetes mellitus
Pediatrics
Puberty as an accelerator for diabetes complications
Pediatr Diabetes
Standards of medical care in diabetes—2010
Diabetes Care
Cited by (109)
Using Natural Language Processing to Identify Different Lens Pathology in Electronic Health Records
2024, American Journal of OphthalmologySystemic and ocular outcomes in patients with young-onset type 2 diabetes
2024, Journal of Diabetes and its ComplicationsAdolescents and type 1 diabetes: A grounded theory on adolescents' experiences of adaptation to type 1 diabetes
2024, Journal of Pediatric NursingDiabetic retinopathy in the pediatric population: Pathophysiology, screening, current and future treatments
2023, Pharmacological ResearchAmerican Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan—2022 Update
2022, Endocrine PracticeCitation Excerpt :The prevalence of diabetic retinopathy is predicted to continue to increase through the next 2 decades.494 Moreover, teenagers and young adults with T1D and T2D diagnosed during childhood (mean 7.8 years duration) have a prevalence of retinopathy of 9.1% and 5.6%, respectively.417,495 Higher levels of glycemia and BP, as well as the presence of nerve and renal diabetic complications, are associated with a greater likelihood of developing retinopathy.496,497
Epidemiology of type 1 diabetes mellitus in children in Kazakhstan: Data from unified national electronic health system 2014-2021
2023, Electronic Journal of General Medicine
See Editorial on page 422.
Financial Disclosure(s): The author(s) have made the following disclosure(s): J.D.S., T.W.G.: Research to Prevent Blindness Physician Scientist Award; J.D.S.: W.K. Kellogg Foundation; T.W.G: Juvenile Diabetes Research Foundation, R01EY20582 and DP3DK094292, the Taubman Institute; W.H.H.: P30DK020572 Michigan Diabetes Research Center; Consultant – Kalvista, Novartis, Novo Nordisk, and the Janssen Research Foundation. No conflicting relationship exists for any other author.
The funding organizations had no role in the design or conduct of this research.
Author Contributions:
Conception and design: Wang, Andrews, Herman, Gardner, Stein
Analysis and interpretation: Wang, Andrews, Herman, Gardner, Stein
Data collection: Wang, Stein
Obtained funding: Stein
Overall responsibility: Wang, Andrews, Herman, Gardner, Stein