496-P: Early-Onset Diabetes Increase the Risk of Referable and Sight-Threatening Diabetic Retinopathy

Objective: This study aimed to investigate the influence of early-onset type 2 diabetes on the risk of developing diabetic retinopathy (DR), referable diabetic retinopathy (referable DR), and sight-threatening diabetic retinopathy (STDR).

Method: A total of 6847 individuals with type 2 diabetes were included. Individuals diagnosed with type 2 diabetes at or before the age of 40 are defined as having early-onset T2DM. Logistic regression and interaction analysis were used to assess the risk of DR, referable DR, and STDR in early versus late-onset diabetes. Kaplan-Meier analysis and cox regression analysis were employed to measure the relationship between incidences of retinopathy and early-onset diabetes in 1507 patients without DR at baseline.

Results: The early-onset group exhibited a higher prevalence of any DR, referable DR, and STDR with a diabetic duration exceeding 5 years (all P<0.05).After adjusting for confounding factors, early-onset diabetes showed a significant association with an increased risk of referable DR and STDR (P=0.02 and P=0.03, respectively), with an interaction based on diabetes duration (P for interaction = 0.01 and P for interaction = 0.02 respectively).In follow-up analysis, the early-onset group had a significantly higher cumulative incidence of referable DR in terms of diabetes duration compared to the late-onset group (12.21% vs 9.8%, P=0.03).The multivariable-adjusted hazard ratios for referable DR in early-onset diabetes were 3.25 (95% CI 1.11-9.47) relative to the late-onset group, only in patients with a duration over 10 years.

Conclusions: Early-onset diabetes increased the risk of referable and sight-threatening DR, especially in those with diabetes duration over 10 years. Enhanced retinal screening and comprehensive diabetes manangement are vital for individuals with early-onset diabetes.