Male Type 2 Diabetic Patients Have Higher Diabetic Retinopathy Prevalence

Diabetic retinopathy (DR) is one of the main causes of visual loss in individuals aged 20-64 years old. Some evidence indicate clear sex gender differences in diabetes complications, but studies focused on sex-gender differences in DR do not give clear data. The aim of this study was to investigate sex gender difference in DR type 2 diabetic patients (T2DM).

Methods: During 2015-2017 in seven diabetic out- patient clinics in Sardinia we examined under midriatic funduscopy 19.951 (11.409 males, 8.542 females) T2DM with known diabetes duration more than 5 years. Patients were classified as having: a) No DR (NRD),b) Mild non proliferative DR (RDNP), c) pre-proliferative and proliferative DR (RDPP), maculopathy (MAC). Each patient had full clinical and laboratory data available. In the same period in three diabetic outpatient clinics we performed also non midriatic retinography in other 1916 T2DM during the outpatient visit using a semi automated digital fundus camera and each imagine was evaluated by an experienced diabetologist/oculist.

Results: Diabetic retinopathy was more frequent under midriatic fundoscopy in males than females: (RDNP 15.9% vs. 14.3%,p<0.01 and RDPP 5,0% vs. 4.0%, p<0.001). Semi automated non midriatic retinography allowed to exclude DR in 68% of patients.

Conclusions: Our preliminary results indicate that: a) In this large sample of T2DM with known diabetes duration more than 5 years, DR is present in 24.1% of the subjects, with unit 3 having the highest prevalence (27.6%) and unit 6 the lowest (16.5%), P<0.00001 b) females have significantly less DR than males (p<0.00001), this effect is evident also excluding Unit 3 p=0.0002. c) retinography may allows to exclude DR in almost 68% of outpatient T2DM patients avoiding the more expensive classical oculist assessment. Further analysis is under way in order to identify possible markers of sex gender difference in DR.