A retrospective review published in JAMA Ophthalmology reveals that eye complications occurred more often and earlier with type 2 diabetes (T2DM) compared to those who have type 1 diabetes (T1DM) in the young.

Medical records of persons from Olmsted County, Minnesota spanning five decades (from January  1970 to December 2019) were reviewed to examine the risk of developing diabetes-associated ocular complications; 606 patients diagnosed with T1DM or T2DM before 22 years of age were finally included in the analysis. The average age at the time of being diagnosed with diabetes was 12 years. The incidence of type 1 diabetes was determined to be 26 per 100,000 children annually; for type 2 diabetes, the incidence was 5 per 100,000 children per year. The prevalence of type 2 diabetes was higher in girls versus type 1 diabetes.

Diabetes-related eye complications occurred more commonly in type 2 diabetes patients (26.6%) compared to type 1 diabetes patients (31.2%). More than half of those (52.7%) with type 2 diabetes developed retinopathy after 15 years of diagnosis versus 30.6% of those with type 1 diabetes; the hazard ratio for any diabetic retinopathy (nonproliferative or greater) was 1.88 and 2.33 for proliferative diabetic retinopathy (PDR). They were also at a greater risk of developing other eye complications such as visually significant cataract (HR 2.43), diabetic macular edema (HR 1.49), or needing pars plana vitrectomy within 15 years of diagnosis (HR 4.06).

This study has shown that among the young persons diagnosed with diabetes, the risk for diabetic retinopathy within the first 15 years of disease was 88% higher in those with T2DM  compared to those with T1DM. Hence, children with T2DM need to undergo more frequent ophthalmoscopic examinations for timely detection of retinopathy and treatment to prevent or delay the risk of loss of vision.

Reference

1. Bai P, et al. Ocular sequelae in a population-based cohort of youth diagnosed with diabetes during a 50-year period. JAMA Ophthalmol. 2021 Dec 2;e215052. doi: 10.1001/jamaophthalmol.2021.5052.