Epidemiology of advanced proliferative diabetic retinopathy in young patients with type I diabetes mellitus

Alvares M.A., Shishkin M.M., Fayzrakhmanov R.R., Kozhevnikov A.A.

Objective: To study the epidemiological history features in young patients with type 1 diabetes (T1D) and advanced diabetic proliferative retinopathy (PDR).

Materials and Methods: Retrospective analysis of medical records and surveyed of 44 young patients (18-44 years old) with advanced PDR. The study included standard ophthalmologic examination, general health assessment by therapist and endocrinologist, necessary laboratory tests, and measurement of glycated hemoglobin (HbA1c) levels.

Results: The study showed poor glycemic control in most patients of this age group, with only 36.4% having HbA1c < 8% at admission. The mean duration of type 1 diabetes was 20.9±4.03 years. Advanced PDR was diagnosed at age under 30 years in 47.7% of cases at first admission. Visual acuity less than 0.1 of the “main” eye was significantly more frequent (70.0%) among rural residents. Despite young age, most patients had severe concomitant somatic pathology.

Conclusion: Diabetic retinopathy in young adults with type 1 diabetes clinically manifests and rapidly progresses between 20–40 years, especially in patients with early diabetes onset. Regular scheduled exams, use of modern technologies such as continuous glucose monitoring sensors, and awareness of diabetic retinopathy features in young T1D patients by both ophthalmologists and patients themselves allow timely diagnosis of disease progression to the proliferative stage and prompt initiation of treatment, including surgical interventions.

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