73000dca8008e839c7e336e9a0fc80f4 310168.pdf d8a708f70fcb50201fcb7ea2ac0bffccb887db9f 310168.pdf 3cab1968e7f7b541ad9dc94316b2d7acef5b58ecf87cb5d0a4b4168383f37302 310168.pdf Title: Incidence of Diabetic Retinopathy in Individuals with Type 2 Diabetes: A Study Using Real-World Data Subject: Background/Objectives: This study aimed to assess the incidence of diabetic retinopathy (DR) in patients with type 2 diabetes (T2DM) treated in primary-care settings in Catalonia, Spain, and identify key risk factors associated with DR development. Methods: A retrospective cohort study was conducted using the SIDIAP (System for Research and Development in Primary Care) database. Patients aged 30–90 with T2DM who underwent retinal screening between 2010 and 2015 were included. Multivariable Cox regression analysis was used to assess the impact of clinical variables, including HbA1c levels, diabetes duration, and comorbidities, on DR incidence. Results: This study included 146,506 patients, with a mean follow-up time of 6.96 years. During this period, 4.7% of the patients developed DR, resulting in an incidence rate of 6.99 per 1000 person-years. Higher HbA1c levels were strongly associated with an increased DR risk, with patients with HbA1c > 10% having more than four times the risk compared to those with HbA1c levels < 7% (hazard ratio: 4.23; 95% CI: 3.90–4.58). Other significant risk factors for DR included greater diabetes duration, male sex, ex-smoker status, macrovascular disease, and chronic kidney disease. In contrast, obesity appeared to be a protective factor against DR, with an HR of 0.93 (95% CI: 0.89–0.98). Conclusions: In our real-world setting, the incidence rate of DR was 6.99 per 1000 person-years. Poor glycemic control, especially HbA1c > 10%, and prolonged diabetes duration were key risk factors. Effective management of these factors is crucial in preventing DR progression. Regular retinal screenings in primary care play a vital role in early detection and reducing the DR burden for T2DM patients. Keywords: diabetic retinopathy; incidence; type 2 diabetes mellitus; microvascular complications; primary care Author: Carlos Hernández-Teixidó, Joan Barrot de la Puente, Sònia Miravet Jiménez, Berta Fernández-Camins, Didac Mauricio, Pedro Romero Aroca, Bogdan Vlacho and Josep Franch-Nadal Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Mon Nov 25 11:30:05 2024 CET ModDate: Mon Nov 25 11:33:06 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 846126 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JODPWK+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 RERWBG+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 ZTDZDS+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 KOHIEB+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 AEPYJE+VnURWPalladioL Type 1 Custom yes yes yes 32 0 DWWZCG+CMSY10 Type 1 Builtin yes yes yes 65 0 ICBUDW+URWPalladioL-BoldItal Type 1 Custom yes yes yes 76 0 DLLIFN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 91 0 DLLIFO+PalatinoLinotype CID TrueType Identity-H yes yes yes 94 0 DLLIGO+PalatinoLinotype TrueType WinAnsi yes yes no 100 0 DLLIHA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 103 0 DLLIFN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 118 0 DLLIFO+PalatinoLinotype CID TrueType Identity-H yes yes yes 121 0 DLLIGO+PalatinoLinotype TrueType WinAnsi yes yes no 127 0 DLLIHA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 130 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-04-04 02:43:22 CEST RepresentationInformation: 310168.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-04-03 10:48:57 CEST Size: 846126 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 289 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design, Setting and Population Destination: subsection.2.1 Item: Title: Definition of Eligibility Criteria Destination: subsection.2.2 Item: Title: Definition of Variables Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Institutional Review Board Statement Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Clinical Characteristics upon Inclusion Destination: subsection.3.1 Item: Title: Incidence of Diabetic Retinopathy and Risk Factors Destination: subsection.3.2 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Incidence of Diabetic Retinopathy in Individuals with Type 2 Diabetes: A Study Using Real-World Data Author: Carlos Hernández-Teixidó, Joan Barrot de la Puente, Sònia Miravet Jiménez, Berta Fernández-Camins, Didac Mauricio, Pedro Romero Aroca, Bogdan Vlacho and Josep Franch-Nadal Subject: Background/Objectives: This study aimed to assess the incidence of diabetic retinopathy (DR) in patients with type 2 diabetes (T2DM) treated in primary-care settings in Catalonia, Spain, and identify key risk factors associated with DR development. Methods: A retrospective cohort study was conducted using the SIDIAP (System for Research and Development in Primary Care) database. Patients aged 30 90 with T2DM who underwent retinal screening between 2010 and 2015 were included. Multivariable Cox regression analysis was used to assess the impact of clinical variables, including HbA1c levels, diabetes duration, and comorbidities, on DR incidence. Results: This study included 146,506 patients, with a mean follow-up time of 6.96 years. During this period, 4.7% of the patients developed DR, resulting in an incidence rate of 6.99 per 1000 person-years. Higher HbA1c levels were strongly associated with an increased DR risk, with patients with HbA1c > 10% having more than four times the risk compared to those with HbA1c levels < 7% (hazard ratio: 4.23; 95% CI: 3.90 4.58). Other significant risk factors for DR included greater diabetes duration, male sex, ex-smoker status, macrovascular disease, and chronic kidney disease. In contrast, obesity appeared to be a protective factor against DR, with an HR of 0.93 (95% CI: 0.89 0.98). Conclusions: In our real-world setting, the incidence rate of DR was 6.99 per 1000 person-years. Poor glycemic control, especially HbA1c > 10%, and prolonged diabetes duration were key risk factors. Effective management of these factors is crucial in preventing DR progression. Regular retinal screenings in primary care play a vital role in early detection and reducing the DR burden for T2DM patients. 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