title: Early-onset type 2 diabetes: high risk for premature diabetic retinopathy.
abstract: OBJECTIVE
  To examine the relationship between early-onset type 2 diabetes (T2D) and retinopathy in relation to the burden, severity, the extent of its premature development and associated predictive risk factors.
  
  
  METHODS
  A cross sectional study using the hospital diabetes register and eye screening database to identify T2D subjects and to ascertain retinopathy severity. Early and later-onset cohort were defined as age of diagnosis <40 and >40 years respectively.
  
  
  RESULTS
  2516 subjects were identified of which 455 were diagnosed below 40 years. After 10 years of diagnosis, the prevalence of overall retinopathy was significantly higher in the early-onset cohort (p < 0.05). For significant retinopathy (SigDR), there was a non-significant trend of higher prevalence with increasing diabetes duration in the early-onset cohort. The rate of increase for SigDR was greater in the early-onset cohort who experienced similar burden of SigDR up to 20 years earlier than the later-onset cohort. Hypertension (p < 0.05), suboptimal glycaemic control (p < 0.05) and long diabetes duration (p < 0.05) were associated with risk of retinopathy whilst lower age of diagnosis and dyslipidaemia were not significant predictive factors.
  
  
  CONCLUSIONS
  Early-onset T2D subjects are at risk of developing premature retinopathy driven predominantly by hypertension and prolonged exposure to suboptimal diabetes control.
authors.affiliation: Diabetes Centre, Northern General Hospital, Sheffield, UK. soon_song@hotmail.com
authors.forename: Soon H
authors.initials: SH
authors.lastname: Song
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Gray
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D018450:Disease Progression; D004739:England / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D007004:Hypoglycemic Agents