Abstract
Purpose :
Poor glycemic control and high blood pressure over time in Type 1 Diabetes Mellitus (T1DM) can lead to Diabetic Retinopathy (DR). Literature supports it is rare to observe DR within the first 3-5 years of diagnosis. We evaluated the effect of a Closed Glucose Monitor Looping (CGML) software on glycemic control and development of DR as well as the role of puberty and comorbidities during these first years of T1DM.
Methods :
Data was collected from 251 subjects with T1DM during an annual screening in Orlando, Florida in 2019, including date of birth, onset of T1DM, blood glucose at time of screening, self-reported hemoglobin a1c, intraocular pressures (IOP), medical history and body mass index (BMI). Prevalence of hypertension (HTN) and BMI were used as markers of comorbid risk factors as both are associated with increased risk of DR. A Canon non-contact puff tonometer (Tokyo, Japan) was used for IOP’s and a Canon non-mydriatic retinal camera CR-2 Plus AF (Tokyo, Japan) was used for evidence of DR. Sample-t tests and analysis of variance tests were used for statistical analysis. This analysis had 155 subjects with ≥ 5 years with T1DM. We isolated 5 subjects that reported CGML.
Results :
Subjects who developed T1DM from ages 10-17 showed the highest prevalence of DR (43%, 13 subjects). Total hemorrhages per subject and prevalence of hemorrhages showed statistically significant (p<0.05) differences between age of onset groups. Subjects who developed T1DM after age 25 showed the highest level of risk factors of BMI (29.26) and HTN (78%). Duration of T1DM did not show significant differences (p=0.36). The 5 subjects that reported CGML displayed no evidence of DR.
Conclusions :
There may be an increased risk for developing DR in subjects diagnosed with T1DM from ages 10-17 or after age 25. Males in the 10-17 age of onset group showed a higher total number of hemorrhages (11.9 vs 1.35 for females) but prevalence of hemorrhages was similar between sexes (0.5 males, 0.4 females). The 26+ group had higher BMI and prevalence of HTN. Our 5 looping subjects displayed no evidence of DR. It is suggested that CGML may be beneficial in glycemic control and development of DR, though further studies with larger numbers of participants need to be performed.
This is a 2020 ARVO Annual Meeting abstract.