title: Diabetic retinopathy and its risk factors in a society with a type 2 diabetes epidemic: a Saudi National Diabetes Registry-based study.
abstract: OBJECTIVE
  To assess diabetic retinopathy prevalence and its risk factors in a society with type 2 diabetes epidemic using the Saudi National Diabetes Registry (SNDR).
  
  
  METHODS
  This is a cross-sectional study using patient's clinical data found in SNDR data base. A cohort of 50,464 Saudi patients with type 2 diabetes aged ≥25 years were selected to assess for the prevalence and risk factors for diabetic retinopathy.
  
  
  RESULTS
  The overall prevalence of diabetic retinopathy is 19.7%, where 9.1% have non-proliferative diabetic retinopathy (NPDR), 10.6% have proliferative diabetic retinopathy (PDR) and 5.7% have macular oedema (ME). Duration of diabetes and age are the most significant risk factors for diabetic retinopathy with odds ratio (OR) and 95% confidence interval (95% CI) 8.88 (8.30-9.50) and 5.76 (5.10-6.55), respectively. Nephropathy, neuropathy, insulin use, poor glycemic control, hypertension and male gender significantly increased the risk for diabetic retinopathy. Smoking, hyperlipidemia and obesity significantly reduced the risk for diabetic retinopathy among type 2 Saudi diabetic cohort.
  
  
  CONCLUSIONS
  vThe low prevalence of diabetic retinopathy in our registry may be a result of the shortage or absence of well-structured screening programmes. Therefore, many patients with NPDR might have been missed. A prevention programme is needed to reduce the effect of diabetic retinopathy risk factors in this society.
authors.affiliation: University Diabetes Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Rubeaan
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Abu El-Asrar
authors.forename: Amira M
authors.initials: AM
authors.lastname: Youssef
authors.forename: Shazia N
authors.initials: SN
authors.lastname: Subhani
authors.forename: Najlaa A
authors.initials: NA
authors.lastname: Ahmad
authors.forename: Ahmad H
authors.initials: AH
authors.lastname: Al-Sharqawi
authors.forename: Abdullah
authors.initials: A
authors.lastname: Alguwaihes
authors.forename: Metib S
authors.initials: MS
authors.lastname: Alotaibi
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Ghamdi
authors.forename: Heba M
authors.initials: HM
authors.lastname: Ibrahim
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D017678:Sex Distribution
keywords: Saudi National Diabetes Registry; diabetic retinopathy; macular oedema; non-proliferative diabetic retinopathy; proliferative diabetic retinopathy; risk factors