Diabetic retinopathy at diagnosis of type 2 diabetes in Scotland.
OBJECTIVE
The aim of this study was to examine the prevalence of and risk factors for diabetic retinopathy in people with newly diagnosed type 2 diabetes mellitus, using Scottish national data.


METHODS
We identified individuals diagnosed with type 2 diabetes mellitus in Scotland between January 2005 and May 2008 using data from the national diabetes database. We calculated the prevalence of retinopathy and ORs for risk factors associated with retinopathy at first screening.


RESULTS
Of the 51,526 people with newly diagnosed type 2 diabetes mellitus identified, 91.4% had been screened by 31 December 2010. The median time to first screening was 315 days (interquartile range [IQR] 111-607 days), but by 2008 the median was 83 days (IQR 51-135 days). The prevalence at first screening of any retinopathy was 19.3%, and for referable retinopathy it was 1.9%. For individuals screened after a year the prevalence of any retinopathy was 20.5% and referable retinopathy was 2.3%. Any retinopathy at screening was associated with male sex (OR 1.19, 95% CI 1.14, 1.25), HbA(1c) (OR 1.07, 95% CI 1.06, 1.08 per 1% [11 mmol/mol] increase), systolic BP (OR 1.06, 95% CI 1.05, 1.08 per 10 mmHg increase), time to screening (OR for screening >1 year post diagnosis = 1.12, 95% CI 1.07, 1.17) and obesity (OR 0.87, 95% CI 0.82, 0.93) in multivariate analysis.


CONCLUSIONS
The prevalence of retinopathy at first screening is lower than in previous UK studies, consistent with earlier diagnosis of diabetes. Most newly diagnosed type 2 diabetic patients in Scotland are screened within an acceptable interval and the prevalence of referable disease is low, even in those with delayed screening.
Medical Research Institute, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, UK, h.c.looker@dundee.ac.uk.
H C
HC
Looker
S O
SO
Nyangoma
D
D
Cromie
J A
JA
Olson
G P
GP
Leese
M
M
Black
J
J
Doig
N
N
Lee
R S
RS
Lindsay
J A
JA
McKnight
A D
AD
Morris
S
S
Philip
N
N
Sattar
S H
SH
Wild
H M
HM
Colhoun
D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012720:Severity of Illness Index; D013997:Time Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human