Abstract
Purpose :
To evaluate the effect on retinopathy, hypertension (HTN) and kidney disease in sickle cell disease (SCD) patients with an added diagnosis of Diabetes Mellitus (DM).
Methods :
This is a cross-sectional study of 743 adult patients with SCD seen at Montefiore Medical Center (Bronx, NY) from January 2014 to June 2020. Patients were categorized as having SCD without DM (n=703) or having SCD and DM (SCD-DM, n=40). Demographics, genotype of SCD (HbSS (SS) or HbSC (SC)) lab values, comorbidities, and ophthalmic complications were collected from the Montefiore electronic medical record (Epic, Verona, WI). Presence of DM, ophthalmic diagnoses and HTN were based on clinical diagnosis in the EMR. Ophthalmic diagnoses were collected in patients who had at least one ophthalmology visit (n= 434). A Chi-Squared test was used for total categorical data, while a Fisher’s Exact test was used for genotype categorical data. A Wilcoxon Two-Sample test was used for continuous variables.
Results :
While there was an increased percentage of retinopathy and proliferative disease in SCD-DM compared to SCD, this relationship was not statistically significant, as seen in Table 1. Increased retinopathy was also noted in patients with SS + DM and in patients with SC + DM compared to the SS and SC group, respectively. While there was an increase in proliferative disease in SS + DM, there was a decrease in proliferative disease in SC + DM, as compared to SS or SC, respectively.
SCD-DM was significantly correlated to increased rate of HTN, higher BMI, and lower GFR in both genotypes, as seen in Table 2. Comparing SS + DM and SS patients, SS + DM had a significantly significant increase in HTN, higher BMI, and lower GFR. A similar statistically significant relationship was seen in patients with SC + DM who had increased rates of HTN, increased BMI, and lower GFR, compared to SC.
Conclusions :
SCD patients with DM were more likely to have a higher BMI, increased rates of HTN and lower GFR than those with SCD alone. While retinopathy remains an important complication in both SCD and DM, there appears to be no statistical difference in retinopathy in SCD-DM versus SCD patients.
This is a 2021 ARVO Annual Meeting abstract.