Differences in retinopathy prevalence and associated risk factors across 11 countries in three continents: A cross-sectional study of 156,090 children and adolescents with type 1 diabetes

Natasa Bratina; Marie Auzanneau; Niels Birkebaek; Carine de Beaufort; Valentino Cherubini; Maria E Craig; Dana Dabelea; Klemen Dovc; Sabine E Hofer; Reinhard W Holl; Elizabeth T Jensen; Dick Mul; Katrin Nagl; Holly Robinson; Ulrike Schierloh; Jannet Svensson; Valentina Tiberi; Henk J Veeze; Justin T Warner; Kim C Donaghue; Australasian Diabetes Data Network (ADDN) Study Group; Steven James; Prospective Diabetes Follow-up Registry (DPV) Initiative; Danish National Diabetes Registry (DanDiabKids); National Pediatric Diabetes Audit (NPDA); Region Marche Registry for Diabetes; Diabeter Diabetes Database; Slovenian Childhood Diabetes Registry; SEARCH for Diabetes in Youth Study

doi:10.1111/pedi.13416

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Differences in retinopathy prevalence and associated risk factors across 11 countries in three continents: A cross-sectional study of 156,090 children and adolescents with type 1 diabetes

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Differences in retinopathy prevalence and associated risk factors across 11 countries in three continents: A cross-sectional study of 156,090 children and adolescents with type 1 diabetes

Natasa Bratina, Marie Auzanneau, Niels Birkebaek, Carine de Beaufort, Valentino Cherubini, Maria E Craig, Dana Dabelea, Klemen Dovc, Sabine E Hofer, Reinhard W Holl, …

Pediatric Diabetes, Vol.23(8), pp.1656-1664

2022

DOI: https://doi.org/10.1111/pedi.13416

PMID: 36097824

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Abstract

adolescents

children

diabetic retinopathy

type 1 diabetes

Objective To examine the prevalence, time trends, and risk factors of diabetic retinopathy (DR) among youth with type 1 diabetes (T1D) from 11 countries (Australia, Austria, Denmark, England, Germany, Italy, Luxemburg, Netherlands, Slovenia, United States, and Wales). Subjects and Methods Data on individuals aged 10–21 years with T1D for >1 year during the period 2000–2020 were analyzed. We used a cross-sectional design using the most recent year of visit to investigate the time trend. For datasets with longitudinal data, we aggregated the variables per participant and observational year, using data of the most recent year to take the longest observation period into account. DR screening was performed through quality assured national screening programs. Multiple logistic regression models adjusted for the year of the eye examination, age, gender, minority status, and duration of T1D were used to evaluate clinical characteristics and the risk of DR. Results Data from 156,090 individuals (47.1% female, median age 15.7 years, median duration of diabetes 5.2 years) were included. Overall, the unadjusted prevalence of any DR was 5.8%, varying from 0.0% (0/276) to 16.2% between countries. The probability of DR increased with longer disease duration (aORper-1-year-increase = 1.04, 95% CI: 1.03–1.04, p < 0.0001), and decreased over time (aORper-1-year-increase = 0.99, 95% CI: 0.98–1.00, p = 0.0093). Evaluating possible modifiable risk factors in the exploratory analysis, the probability of DR increased with higher HbA1c (aORper-1-mmol/mol-increase-in-HbA1c = 1.03, 95% CI: 1.03–1.03, p < 0.0001) and was higher among individuals with hypertension (aOR = 1.24, 95% CI: 1.11–1.38, p < 0.0001) and smokers (aOR = 1.30, 95% CI: 1.17–1.44, p < 0.0001). Conclusions The prevalence of DR in this large cohort of youth with T1D varied among countries, increased with diabetes duration, decreased over time, and was associated with higher HbA1c, hypertension, and smoking.

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Title: Differences in retinopathy prevalence and associated risk factors across 11 countries in three continents: A cross-sectional study of 156,090 children and adolescents with type 1 diabetes
Authors: Natasa Bratina (Corresponding Author) - Ljubljana University Medical Centre
Marie Auzanneau - Universität Ulm
Niels Birkebaek - Aarhus University Hospital
Carine de Beaufort - Centre Hospitalier de Luxembourg
Valentino Cherubini
Maria E Craig - Children's Hospital at Westmead
Dana Dabelea - University of Colorado Anschutz Medical Campus
Klemen Dovc - University of Ljubljana
Sabine E Hofer - University of Innsbruck
Reinhard W Holl - Universität Ulm
Elizabeth T Jensen - Wake Forest University
Dick Mul
Katrin Nagl - Medical University of Vienna
Holly Robinson - Royal College of Paediatrics and Child Health
Ulrike Schierloh - Centre Hospitalier de Luxembourg
Jannet Svensson - Gentofte Hospital
Valentina Tiberi - Ospedali Riuniti di Ancona
Henk J Veeze
Justin T Warner - Noah's Ark Children's Hospital for Wales
Kim C Donaghue - Children's Hospital at Westmead
Australasian Diabetes Data Network (ADDN) Study Group (Research Group)
Steven James (Group Member) - University of the Sunshine Coast, Queensland, School of Health - Nursing
Prospective Diabetes Follow-up Registry (DPV) Initiative (Research Group)
Danish National Diabetes Registry (DanDiabKids) (Research Group)
National Pediatric Diabetes Audit (NPDA) (Research Group)
Region Marche Registry for Diabetes (Research Group)
Diabeter Diabetes Database (Research Group)
Slovenian Childhood Diabetes Registry (Research Group)
SEARCH for Diabetes in Youth Study (Research Group)
Publication details: Pediatric Diabetes, Vol.23(8), pp.1656-1664
Publisher: Wiley-Blackwell Publishing, Inc.
Date published: 2022
DOI: 10.1111/pedi.13416
ISSN: 1399-5448
PMID: 36097824
Copyright note: © 2022 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Data Availability: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Organisation Unit: School of Health - Nursing
Language: English
Record Identifier: 991103246202621
Output Type: Journal article

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Web Of Science research areas: Endocrinology & Metabolism; Pediatrics

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