Association of continuous subcutaneous insulin therapy and diabetic retinopathy in type 1 diabetes: A national cohort study.

Autor: Thykjær AS; Department of Ophthalmology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark. Electronic address: anne.suhr.thykjaer@rsyd.dk., Rosengaard L; Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Andersen N; Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark., Andresen J; Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark. Electronic address: d046531@dadlnet.dk., Hajari J; Department of Ophthalmology, Zealand University Hospital Roskilde, Roskilde, Denmark. Electronic address: javad.nouri.hajari@regionh.dk., Heegaard S; Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark. Electronic address: sthe@sund.ku.dk., Højlund K; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark. Electronic address: Kurt.Hoejlund@rsyd.dk., Kawasaki R; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan. Electronic address: ryo.kawasaki@ophthal.med.osaka-u.ac.jp., Laugesen CS; Department of Ophthalmology, Zealand University Hospital Roskilde, Roskilde, Denmark. Electronic address: csla@regionsjaelland.dk., Möller S; Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: Soren.Moller@rsyd.dk., Pedersen FN; Department of Ophthalmology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: Frederik.N.Pedersen@rsyd.dk., Schielke K; Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark. Electronic address: kcs@rn.dk., Stokholm LM; Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: Lonny.Merete.Stokholm@rsyd.dk., Grauslund J; Department of Ophthalmology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark. Electronic address: Jakob.Grauslund@rsyd.dk.
Jazyk: angličtina
Zdroj: Journal of diabetes and its complications [J Diabetes Complications] 2024 Sep; Vol. 38 (9), pp. 108830. Date of Electronic Publication: 2024 Jul 25.
DOI: 10.1016/j.jdiacomp.2024.108830
Abstrakt: Aim: This study aimed to investigate the short-and long-term effect on diabetic retinopathy (DR) in individuals with type 1 diabetes treated with continuous subcutaneous insulin injections (CSII) compared to those using multiple daily injections (MDI).
Methods: We conducted a register-based matched cohort study utilizing data from the Danish Registry of Diabetic Retinopathy as well as several other national Danish health registers. Our cohort consisted of all individuals with type 1 diabetes who attended the Danish screening program for DR from 2013 to 2022. We included individuals registered with CSII treatment, and compared them to individuals using MDI, matched by age, sex, and DR level. Cox regression analysis was performed to evaluate the outcomes.
Results: The study included 674 individuals treated with CSII and 2006 matched MDI users. In our cohort 53.4 % were female and median age was 36 (IQR 27-47). Average follow-up risk-time was 4.8 years. There was no difference in the risk of DR worsening between the CSII group and MDI group (HR 1.05 [95%CI 0.91; 1.22], p = 0.49). However, an increased risk of focal photocoagulation was observed in the CSII group (HR 2.40 [95%CI 1.11; 5.19], p = 0.03).
Conclusions: Our findings indicate that CSII treatment does not confer a significant difference in the overall short- and long-term risk of DR worsening or ocular intervention compared to MDI treatment. These results provide insights into the DR outcomes of CSII treatment in individuals with type 1 diabetes.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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