Age at Onset of Type 1 Diabetes Influences Risk of Macular Edema
The study, published online ahead of print in the journal Acta Ophthalmologica, is titled “Higher age at onset of type 1 diabetes increases risk of macular oedema.” Led by researchers at the Folkhälsan Institute of Genetics in Helsinki, Finland, the study examined data on 1,354 patients who lived with diabetes for a mean of 24.6 ± 11.6 years. The study sample was drawn from the Finnish Diabetic Nephropathy Study (FinnDiane) population.
Participants were divided into groups based on the age at which they developed type 1 diabetes. The groups included a 0-4 onset group (n=184), a 5-14 onset group (n=662), and a group who developed the condition between the ages of 15 and 40 (n=508). Patients’ retinopathy status was measured using fundus photographs, stereoscopic fundus examinations, and ETDRS [Early Treatment Diabetic Retinopathy Study] scores.
The results showed that after patients lived with diabetes for 30 years, the incidence of CSME in the 0-4 years at onset group was 17%; for the 5-14 years at onset group, it was 27%; and, for the oldest group (15-40 years), incidence of CSME was 34% (p = 0.002, Gray's test). After completing a competing risks regression model and adjusting for covariates (using Bayesian information criteria), researchers found the 2 oldest onset groups (5-14 years and 15-40 years) to be significant risk factors for CSME. Additionally, a person’s total cholesterol level also raised their risk of CSME.
The study authors conclude that the older a person is at the onset of type 1 diabetes, the higher their risk of developing macular edema. They note that this suggests that the process of aging might modify a person’s risk of retinopathy if they have type 1 diabetes.