Risk factors of diabetic retinopathy in Bangladeshi type 2 diabetic patients

Aims: To determine the risk factors associated with diabetic retinopathy (DR) in Bangladeshi type 2 diabetic subjects. Methods: A cohort of 977 type-2 diabetic patients was recruited retrospectively based on hospital records in 2008, who were naive type-2 diabetes during 1993. Data on diabetes and lipid profile with serum creatinine and biophysical measures were obtained at baseline, 5, 10 and 15 years. DR was diagnosed by retinal color photography. Generalized linear models were used to assess the associations of clinical, biochemical and anthropometric variables with retinopathy at three follow-up. Cumulative exposures were determined based on average exposure to individual attribute. IRR and 95% CI were generated through Poisson regression model, adjusting for age-at-diagnosis of diabetes, baseline BMI, end-line waist-to-hip ratio and present physical activity status. Results: DR patients had significantly poorer glycemic control at all three follow-ups. Age, residence, physical activity, serum creatinine and hypertension appeared as independent risk factors for DR in all three follow-up points. Poisson regression model identified glucose deregulation (IRR 1.8; CI 1.5-2.1), hypertension (IRR 1.5; CI 1.2-1.8) and raised serum creatinine (IRR 1.9; CI 1.5-2.3) as significant predictors for DR adjusted for possible confounders. Work related moderate-to-heavy physical activity (IRR 0.2; CI 0.1-0.3) appeared as protective. Conclusions: Along with poor glycemic control, hypertension, nephropathy are independent risk factor retinopathy. (C) 2012 Published by Elsevier Ltd on behalf of Diabetes India.