TY - JOUR

T1 - Differences in retinopathy prevalence and associated risk factors across 11 countries in three continents

T2 - A cross-sectional study of 156,090 children and adolescents with type 1 diabetes

AU - Bratina, Natasa

AU - Auzanneau, Marie

AU - Birkebæk, Niels

AU - de Beaufort, Carine

AU - Cherubini, Valentino

AU - Craig, Maria E.

AU - Dabelea, Dana

AU - Dovc, Klemen

AU - Hofer, Sabine E.

AU - Holl, Reinhard W.

AU - Jensen, Elizabeth T.

AU - Mul, Dick

AU - Nagl, Katrin

AU - Robinson, Holly

AU - Schierloh, Ulrike

AU - Svensson, Jannet

AU - Tiberi, Valentina

AU - Veeze, Henk J.

AU - Warner, Justin T.

AU - Donaghue, Kim C.

AU - Australasian Diabetes Data Network (ADDN) Study Group, the Prospective Diabetes Follow-up Registry (DPV) initiative, Danish National Diabetes Registry (DanDiabKids), National Pediatric Diabetes Audit (NPDA), Region Marche Registry for Diabetes, Diabeter D

N1 - Publisher Copyright: © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2022

Y1 - 2022

N2 - Objective: To examine the prevalence, time trends, and risk factors of diabetic retinopathy (DR) among youth with type 1 diabetes (T1D) from 11 countries (Australia, Austria, Denmark, England, Germany, Italy, Luxemburg, Netherlands, Slovenia, United States, and Wales). Subjects and Methods: Data on individuals aged 10–21 years with T1D for >1 year during the period 2000–2020 were analyzed. We used a cross-sectional design using the most recent year of visit to investigate the time trend. For datasets with longitudinal data, we aggregated the variables per participant and observational year, using data of the most recent year to take the longest observation period into account. DR screening was performed through quality assured national screening programs. Multiple logistic regression models adjusted for the year of the eye examination, age, gender, minority status, and duration of T1D were used to evaluate clinical characteristics and the risk of DR. Results: Data from 156,090 individuals (47.1% female, median age 15.7 years, median duration of diabetes 5.2 years) were included. Overall, the unadjusted prevalence of any DR was 5.8%, varying from 0.0% (0/276) to 16.2% between countries. The probability of DR increased with longer disease duration (aORper-1-year-increase = 1.04, 95% CI: 1.03–1.04, p < 0.0001), and decreased over time (aORper-1-year-increase = 0.99, 95% CI: 0.98–1.00, p = 0.0093). Evaluating possible modifiable risk factors in the exploratory analysis, the probability of DR increased with higher HbA1c (aORper-1-mmol/mol-increase-in-HbA1c = 1.03, 95% CI: 1.03–1.03, p < 0.0001) and was higher among individuals with hypertension (aOR = 1.24, 95% CI: 1.11–1.38, p < 0.0001) and smokers (aOR = 1.30, 95% CI: 1.17–1.44, p < 0.0001). Conclusions: The prevalence of DR in this large cohort of youth with T1D varied among countries, increased with diabetes duration, decreased over time, and was associated with higher HbA1c, hypertension, and smoking.

AB - Objective: To examine the prevalence, time trends, and risk factors of diabetic retinopathy (DR) among youth with type 1 diabetes (T1D) from 11 countries (Australia, Austria, Denmark, England, Germany, Italy, Luxemburg, Netherlands, Slovenia, United States, and Wales). Subjects and Methods: Data on individuals aged 10–21 years with T1D for >1 year during the period 2000–2020 were analyzed. We used a cross-sectional design using the most recent year of visit to investigate the time trend. For datasets with longitudinal data, we aggregated the variables per participant and observational year, using data of the most recent year to take the longest observation period into account. DR screening was performed through quality assured national screening programs. Multiple logistic regression models adjusted for the year of the eye examination, age, gender, minority status, and duration of T1D were used to evaluate clinical characteristics and the risk of DR. Results: Data from 156,090 individuals (47.1% female, median age 15.7 years, median duration of diabetes 5.2 years) were included. Overall, the unadjusted prevalence of any DR was 5.8%, varying from 0.0% (0/276) to 16.2% between countries. The probability of DR increased with longer disease duration (aORper-1-year-increase = 1.04, 95% CI: 1.03–1.04, p < 0.0001), and decreased over time (aORper-1-year-increase = 0.99, 95% CI: 0.98–1.00, p = 0.0093). Evaluating possible modifiable risk factors in the exploratory analysis, the probability of DR increased with higher HbA1c (aORper-1-mmol/mol-increase-in-HbA1c = 1.03, 95% CI: 1.03–1.03, p < 0.0001) and was higher among individuals with hypertension (aOR = 1.24, 95% CI: 1.11–1.38, p < 0.0001) and smokers (aOR = 1.30, 95% CI: 1.17–1.44, p < 0.0001). Conclusions: The prevalence of DR in this large cohort of youth with T1D varied among countries, increased with diabetes duration, decreased over time, and was associated with higher HbA1c, hypertension, and smoking.

KW - adolescents

KW - children

KW - diabetic retinopathy

KW - type 1 diabetes

U2 - 10.1111/pedi.13416

DO - 10.1111/pedi.13416

M3 - Journal article

C2 - 36097824

AN - SCOPUS:85138668562

VL - 23

SP - 1656

EP - 1664

JO - Pediatric Diabetes

JF - Pediatric Diabetes

SN - 1399-543X

IS - 8

ER -