Prevalence, severity stages, and risk factors of diabetic retinopathy in 1464 adult patients with type 1 diabetes

Graefes Arch Clin Exp Ophthalmol. 2021 Dec;259(12):3613-3623. doi: 10.1007/s00417-021-05298-7. Epub 2021 Jul 15.


Purpose: To determine the prevalence of diabetic retinopathy (DR) and its risk factors in adult type 1 diabetes (T1D) patients METHODS: In this cross-sectional study, all T1D patients followed in the University Center for Diabetes and its Complications of Lariboisière Hospital (Paris, France) between January 2017 and February 2019 were included. Ophthalmologic and systemic data were collected from electronic records. The association between DR (and each grade) and associated factors were estimated by univariate and multivariate analyses using logistic regression models.

Results: A total of 1464 patients (46.2% of women, mean age: 42.2 ± 15.8 years) were included. The mean hemoglobin A1c (HbA1c) was 7.8 ± 1.7% and the mean diabetes duration was 20.5 ± 13.5 years. DR prevalence was 50.1% (47.4-52.6) and the prevalence of mild, moderate, and severe non-proliferative DR and proliferative DR was 19.1%, 9.4%, 3.9%, and 17.6%, respectively. DR was significantly associated with male gender, an older age, former and current smoking status, a higher BMI, the presence of nephropathy and neuropathy, higher HBA1c, and longer diabetes duration. Patients with HbA1c > 10% had an adjusted odds ratio (OR) of 3.25 (1.77-6.01) of having DR compared to patients with HbA1c < 6.5%. Patients with a diabetes duration > 30 years had an adjusted OR of 24.87 (14.82-42.67) higher of having DR compared to patients with a diabetes duration < 10 years.

Conclusion: In this study, 50.1% of adult T1D patients had DR and 17.6% had proliferative DR. Diabetes duration and HbA1c were major risk factors.

Keywords: Diabetic retinopathy; Epidemiology; Prevalence; Risk factors; Type 1 diabetes.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / epidemiology
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / epidemiology
  • Female
  • Glycated Hemoglobin
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors


  • Glycated Hemoglobin A