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05-05-2024 | Diabetic Retinopathy | Original Article

Impact of treatment cessation on incidence and progression of retinopathy in Japanese patients with type 2 diabetes mellitus: a retrospective cohort study

Authors: Yukiko Shinzato, Yoshiro Nakayama, Shiki Okamoto, Jasmine F. Millman, Tsugumi Uema, Ken-ichiro Honma, Atsuko Tamaki, Moriyuki Uehara, Taiki Teruya, Takamitsu Yabiku, Yohei Ishiki, Ken Yonaha, Ko-ichiro Arakaki, Moritake Higa, Hideki Koizumi, Koshi Nakamura, Michio Shimabukuro, Hiroaki Masuzaki

Published in: Diabetology International | Issue 3/2024

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Abstract

Aims

This cohort study investigated the association between treatment cessation and incidence/progression of diabetic retinopathy (DR) in Japanese patients with type 2 diabetes mellitus (T2DM).

Materials and methods

Data were extracted from electronic medical records at the University of the Ryukyu Hospital and the Tomishiro Central Hospital of Okinawa, Japan. We enrolled 417 diabetic patients without DR (N = 281) and with nonproliferative DR (N = 136) at the baseline. Treatment cessation was defined as failing to attend outpatient clinics for at least twelve months prior to the baseline. After a median follow-up of 7 years, we compared the incidence/progression rate of DR including nonproliferative and proliferative DR between patients with and without treatment cessation and calculated the odds ratio (OR) in the treatment cessation group using a logistic regression model.

Results

The overall prevalence of treatment cessation was 13% in patients with T2DM. Characteristics of treatment cessation included relative youth (57 ± 11 years vs. 63 ± 12 years, P < 0.01). Treatment cessation was tightly associated with the incidence of DR (OR 4.20 [95% confidence interval [CI] 1.46–12.04, P < 0.01) and also incidence/progression of DR (OR 2.70 [1.28–5.69], P < 0.01), even after adjusting for age, sex, BMI, duration of T2DM, and HbA1c level.

Conclusions

By considering major confounding factors, the present study demonstrates an independent association between treatment cessation and incidence of DR in patients with T2DM, highlighting treatment cessation as an independent risk for DR in T2DM.
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Metadata
Title
Impact of treatment cessation on incidence and progression of retinopathy in Japanese patients with type 2 diabetes mellitus: a retrospective cohort study
Authors
Yukiko Shinzato
Yoshiro Nakayama
Shiki Okamoto
Jasmine F. Millman
Tsugumi Uema
Ken-ichiro Honma
Atsuko Tamaki
Moriyuki Uehara
Taiki Teruya
Takamitsu Yabiku
Yohei Ishiki
Ken Yonaha
Ko-ichiro Arakaki
Moritake Higa
Hideki Koizumi
Koshi Nakamura
Michio Shimabukuro
Hiroaki Masuzaki
Publication date
05-05-2024
Publisher
Springer Nature Singapore
Published in
Diabetology International / Issue 3/2024
Print ISSN: 2190-1678
Electronic ISSN: 2190-1686
DOI
https://doi.org/10.1007/s13340-024-00724-7

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