Comparing Teleretinal Screening-Identified Diabetic Retinopathy With Diabetic Nephropathy and Other Markers of Systemic Disease

Purpose: Diabetic retinopathy and diabetic nephropathy are two major life-altering complications of diabetes mellitus. Identifying permissive and protective factors for diabetic retinopathy and nephropathy is imperative so that diabetic quality of life can be optimized and downstream complications can be minimized. Methods: We performed a large retrospective chart review of 997 patients at a county medical center with a majority Hispanic population. Through multivariable regression analysis, we identified significant factors associated with the presence of diabetic retinopathy or diabetic nephropathy. We also identified patients with a discordance between diabetic control and the severity of diabetic retinopathy and nephropathy. Results: Chronic kidney disease, baseline HbA1c, and systolic blood pressure were found to be positive risk factors for both diabetic retinopathy and diabetic nephropathy. Beta-blocker use and insulin use were identified as positive risk factors for diabetic retinopathy but not diabetic nephropathy. A higher body metabolic index (BMI) was found to be protective for diabetic retinopathy. We identified 7 patients with poor diabetic control (HbA1c >10%) but no diabetic retinopathy. There were no outlier patients found in the low glycemic exposure group. Conclusions and Importance: Our results are similar to other large-cohort reviews identifying factors associated with diabetic retinopathy and nephropathy. We identified a small cohort with discordance between diabetic control and the development of diabetic retinopathy or nephropathy. Future studies should be conducted looking into reasons for the anomalous progression of disease in certain patients.