One type had a higher risk for all diabetes-related ocular complications Type 2 diabetes may pose a greater
threat to the eyes than type 1 diabetes, a retrospective review suggested.
In over 600 individuals with youth-onset diabetes, every diabetic eye-related complication assessed was more common among those with type 2 diabetes versus those with type 1 diabetes, reported Brian G. Mohney, MD, of the Mayo Clinic in Rochester, Minnesota, and colleagues in JAMA Ophthalmology.
After having diabetes for 15 years, 30.6% of those with type 1 diabetes developed either form of retinopathy versus 52.7% of those with type 2 diabetes.
Specifically, people with youth-onset type 2 diabetes had an 88% higher risk for any type of diabetic retinopathy — nonproliferative (NPDR) or greater — compared with those with type 1 diabetes (95% CI 1.13-3.12, P=0.02).
On top of that, those with type 2 diabetes also had a significantly greater risk for developing other serious ocular complications:
Proliferative diabetic retinopathy (PDR): HR 2.33 (95% CI 0.99-5.50, P=0.048) Diabetic macular edema (DME): HR 1.49 (95% CI 0.46-4.89, P=0.50) Visually significant cataract: HR 2.43 (95% CI 0.54-11.07, P=0.24) Requiring pars plana vitrectomy within 15 years of diagnosis: HR 4.06 (95% CI 1.34-12.33, P=0.007) In comparing ages of onset, the youngest ages of diagnosis of NPDR, PDR, and DME were 12.6, 18.4, and 19.9 years, respectively, for those with type 1 diabetes compared with 21.4, 23.5, and 23.8 years, respectively, for those with type 2 diabetes.
“This suggests that the natural history of retinopathy development among youth diagnosed with type 2 diabetes may differ from that in youth diagnosed with type 1 diabetes, where patients with [type 2] may be more susceptible to developing retinopathy than those with [type 1] despite controlling for diabetes disease duration,” the researchers explained.
