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Title: Retinopathy in youth with type 2 diabetes participating in the TODAY clinical trial

Author
item HAYMOND, MOREY - Children'S Nutrition Research Center (CNRC)
item TODAY STUDY GROUP - Consultant

Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/21/2013
Publication Date: 6/3/2013
Citation: Today Study Group. 2013. Retinopathy in youth with type 2 diabetes participating in the TODAY clinical trial. Diabetes Care. 36(6):1772-1774.

Interpretive Summary: To determine the prevalence of eye complications of diabetes (retinopathy) 517 youth with type 2 diabetes of 2–8 years duration enrolled in the TODAY study were studied. Photographs of the back of the eye (Retinal photographs) were graded centrally using established standards. Retinopathy was identified in 13.7% of subjects. Prevalence was higher in those who were older, had diabetes longer, and in whom diabetes control was worse. For unexplained reasons, subjects who were most obese (the highest BMI tertile) had the lowest prevalence of retinopathy. Prevalence of retinopathy and its association with glucose control and duration of diabetes is similar to that previously reported in youth with type 1 diabetes and in adults with type 2 diabetes of known duration. The mechanism underlying the reduced risk of retinopathy in the most obese individuals is unknown. Follow-up of this cohort will help define the natural history of the eye complications in youth with type 2 diabetes.

Technical Abstract: The objective of this study was to determine the prevalence of retinopathy in 517 youth with type 2 diabetes of 2–8 years duration enrolled in the TODAY study. Retinal photographs were graded centrally for retinopathy using established standards. Retinopathy was identified in 13.7% of subjects. Prevalence increased with age, diabetes duration, and mean HbA1c. Subjects in the highest BMI tertile had the lowest prevalence of retinopathy. Prevalence of retinopathy and its association with HbA1c and diabetes duration is similar to that previously reported in youth with type 1 diabetes and in adults with type 2 diabetes of known duration. The mechanism underlying the reduced risk of retinopathy in the most obese individuals is unknown. Follow-up of this cohort will help define the natural history of retinopathy in youth with type 2 diabetes.