Visual Abstract
Most prevalence estimates for diabetic retinopathy (DR) in youth are from limited data in selected populations and may not represent true prevalence. The SEARCH for Diabetes in Youth study included a longitudinal cohort of youth-onset T1D and T2D (2001-2020). Using retinal photos (left and right eyes) obtained on cohort participants (n=2519 T1D and n=447 T2D at first follow-up and n=1014 T1D and n=239 T2D at second follow-up), we characterized the prevalence of mild, moderate and proliferative DR (worst eye). Overall prevalence was standardized to the sex and race/ethnicity distribution of registered cases (n=7,277). At first retinal photo [mean (std) disease duration of 7.7(2.0) years for T1D and 7.5(2.1) years for T2D], the prevalence of DR (all grades) for T1D was 21.3/100 cases (95% CI: 19.5, 23.1) and for T2D it was 31.3/100 cases (95% CI: 26.8, 35.9). By the second photo [mean (std) of 12.5 (2.2) years post dx for T1D and 12.4 (2.1) years for T2D] the prevalence was 52.0/100 cases (95% CI: 48.6, 55.3) for T1D and 55.7/100 cases (95% CI: 48.7, 62.7) for T2D (Table). Compared to other groups, a higher proportion of non-Hispanic Black participants had evidence of DR, all grades combined (p<0.05 for both T1D and T2D). Proliferative DR was uncommon. Research to identify modifiable risk factors, early in disease course, as well as socioeconomic determinants, may offer opportunity to reduce risk.
E. T. Jensen: None. B. E. Klein: None. S. Meuer: None. E. J. Mayer-davis: None. J. Rigdon: None. K. Rezaei: None. E. A. Lundeen: None. D. Dabelea: None. S. Saydah: None. L. M. Dolan: None. R. Dagostino: Consultant; Self; AstraZeneca, Biogen, Daiichi Sankyo. A. K. Mottl: Advisory Panel; Self; Bayer U. S.
