medwireNews: Almost half of people diagnosed with type 2 diabetes in childhood develop retinopathy by their mid-20s, show TODAY2 data.
“Of clinical concern, the prevalence of [diabetic retinopathy] in our cohort is nearly twice the 28.5% prevalence reported for adults with type 2 diabetes aged 40 years and older with an average diabetes duration of 15 years,” write the researchers in Diabetes Care.
Kimberly Drews (George Washington University, Rockville, Maryland, USA) and study co-authors examined fundus photographs taken of 367 young people with type 2 diabetes in 2010–2011 and again in 2017–2018 as part of the TODAY and TODAY2 studies.
The study participants were an average of 18.4 years old at the time of the first exam, with an average diabetes duration of 4.9 years, and at this point 13.9% had diabetic retinopathy, which was mild in all cases.
But by the time of the second exam, at an average age of just 25.4 years, 49% had diabetic retinopathy, with 1.4% having progressed to severe nonproliferative retinopathy, 2.7% to early or stable treated proliferative retinopathy, and 1.0% to high-risk proliferative retinopathy. Also, 3.8% had clinically significant macular edema.
Glycated hemoglobin was the most important predictor of retinopathy progression between the two exams, with each percentage point rise associated with nearly a twofold increased risk in multivariate analysis.
The researchers stress that “aggressive management of glycemia” and annual screening in youth with diabetes are “critical to preserve vision into adulthood.”
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