Population-based study of nonproliferative diabetic retinopathy among type 2 diabetic patients in Kinmen, Taiwan

Purpose: This study was conducted to assess the prevalence and associated factors of nonproliferative diabetic retinopathy among type 2 diabetic patients in Kinmen, Taiwan. Methods: From 1991 to 1993, 971 type 2 diabetic patients in Kinmen underwent diabetic retinopathy screening performed by a panel of ophthalmologists using indirect ophthalmoscopy and 45 degrees color fundus retinal photographs. Results: Of the 971 patients screened in 1991-1993, 578 (59.5%) were examined for this study. Diabetic retinopathy was diagnosed in 127 patients (22.0%), including nonproliferative diabetic retinopathy in 13.3%, proliferative diabetic retinopathy in 1.4%, legal blindness in 1.4%, and ungradable diabetic retinopathy in 5.9%. Significant associated factors of nonproliferative diabetic retinopathy based on multiple logistic regression analysis were fasting plasma glucose (FPG) at baseline [>= 126 mg/dl vs. < 126 mg/dl; odds ratio (OR) 2.89; 95% confidence interval (CI), 1.01-9.09], 2-h postload at baseline (>= 200 vs. < 200mg/dl; OR 1.48; 95% CI, 1.09-2.07); HbA(1c) at follow-up (>= 7% vs. < 7%; OR = 6.54; 95% CI, 3.01-14.20), duration of diabetes (>= 15 years vs. < 10 years; OR = 6.72; 95% CI, 2.13-21.18), and incremental systolic blood pressure between baseline and follow-up (OR = 1.02; 95% CI 1.00-1.04). Conclusions: In addition to the longer duration of type 2 diabetes, FPG at baseline, poorly controlled glucose concentration, and altered blood pressure may increase the risk of nonproliferative diabetic retinopathy in type 2 diabetic patients.