Diabetic retinopathy in T1DM linked to HbA1c, albuminuria, HDL cholesterol

The incidence of diabetic retinopathy and its progression in patients with type 1 diabetes mellitus (T1DM) is still high, especially in the presence of high HbA1c, albuminuria, and low high-density lipoprotein (HDL) cholesterol levels, as reported in a study.

The study included 123 T1DM patients who were followed for 15 years. Researchers collected and analysed demographic, clinical, laboratory parameters, and retinal photographs. They identified risk factors for diabetic retinopathy development and progression using Cox regression analysis.

At baseline, 87 (71 percent) patients had no diabetic retinopathy while 36 (29 percent) had nonproliferative diabetic retinopathy (NPDR). Over 15 years of follow-up, 54 patients (43.9 percent; 29.3 per 1,000 person-years) developed NPDR and 30 (83.3 percent) progressed to proliferative DR (PDR).

Risk factors for diabetic retinopathy development and progression included elevated HbA1c (hazard ratio [HR], 1.48; p=0.008) and urinary albumin excretion rate (HR, 1.58; p=0.045). The presence of diabetic retinopathy at baseline was also associated with an increased risk of progression to PDR (HR, 2.95; p=0.023).

On the other hand, high HDL cholesterol levels were protective (HR, 0.17; p=0.021).

The findings point to the need for close monitoring of T1DM, especially those patients with higher HbA1c, higher albumin excretion rate, the initial presence of DR, and lower HDL cholesterol.