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A 50-year longitudinal study of diabetes on ocular complications in youth-onset type-2 diabetes (T2D) and type 1 diabetes (T1D) suggest different risks on retinopathy

New longitudinal research in diabetes over a 50-year period in a US study reported that children with type-2 diabetes (T2D) had almost twice the risk of developing retinopathy compared with those with type-1 diabetes (T1D). It is well known that diabetes is an enormous epidemic globally and that the disease is expected to affect more than 700 million individuals worldwide by the year 2045. The current findings from researchers at the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, suggest “that to prevent serious ocular complications, children with T2D may require ophthalmoscopic evaluations at least as frequently as or more frequently than children with T1D”.


The research study reported in JAMA Ophthalmology (Dec. 2nd, 2021) was aimed to assess the risk of developing diabetes-associated ocular complications among youth (aged <22 years) diagnosed with diabetes.  The retrospective analyses used a population-based medical record review including all residents in one area of Olmsted County, Minnesota, with patients diagnosed with diabetes at younger than 22 years over a longitudinal 50-year period (from January 1, 1970, through to December 31, 2019).  According to the data, a total of 606 children were diagnosed with diabetes over the 50-year period, yielding an incidence of T1D of 26 per 100,000 children per year, while T2D occurred an incidence of 5 per 100,000 per year. The researchers reported their results that five hundred twenty-five (525) participants (86.6%) had undergone at least 1 eye examination and sufficiently met diagnostic criteria to distinguish between T1D (461 [87.8%]), and T2D (64 [12.2%]), after which they were followed up for a mean (SD) of 13.6 (9.4) years (range, 1 day to 37.1 years), and 8.6 (6.9) years (range, 17 days to 23.9 years), respectively. Finally, the mean (SD) age at diabetes diagnosis was 12.1 (5.4) years (range, 73 days to 21.8 years) with 261 participants (49.7%) were female and 264 participants (50.3%) were male.


In summary, this 50-year population-based cohort, showed that children diagnosed with T2D had a higher risk of developing diabetic retinopathy, developing proliferative diabetic retinopathy (PDR), and requiring pars plana vitrectomy (PPV) compared with those diagnosed with T1D.  Researchers concluded from the study suggest that “children with T2D have a higher risk of developing retinopathy than those with T1D, potentially requiring earlier surveillance and intervention to prevent vision-threatening complications”.