Age at Onset of Type 1 Diabetes Influences Risk of Macular Edema

The age at which a person develops type 1 diabetes may affect their risk for clinically significant macular edema (also spelled as oedema) (CSME), according to Digital vision concept, abstract illustration with chaotic structures mixed with human eyeresearch.

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.

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