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Cited by 131Retinal Diseases and TreatmentsChronic Kidney Disease and DiabetesDiabetes Management and Research

Risk Factors for Retinopathy and DME in Type 2 Diabetes—Results from the German/Austrian DPV Database

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Hammes, Hans-Peter, Welp, Reinhard, Kempe, Hans-Peter, Wagner, Christian, Siegel, Erhard, Holl, Reinhard W., DPV Initiative—German BMBF Competence Network Diabetes Mellitus·2015·PLOS ONE
DOI 10.1371/journal.pone.0132492PMC PMC4503301
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Abstract

To assess the prevalence and risk factors for early and severe diabetic retinopathy and macular edema in a large cohort of patients with type 2 diabetes Retinopathy grading (any retinopathy, severe retinopathy, diabetic macular edema) and risk factors of 64784 were prospectively recorded between January 2000 and March 2013 and analyzed by Kaplan-Meier analysis and logistic regression. Retinopathy was present in 20.12% of subjects, maculopathy was found in 0.77%. HbA1c > 8%, microalbuminuria, hypertension, BMI > 35 kg/m2 and male sex were significantly associated with any retinopathy, while HbA1c and micro- and macroalbuminuria were the strongest risk predictors for severe retinopathy. Presence of macroalbuminuria increased the risk for DME by 177%. Retinopathy remains a significant clinical problem in patients with type 2 diabetes. Metabolic control and blood pressure are relevant factors amenable to treatment. Concomitant kidney disease identifies high risk patients and should be emphasized in interdisciplinary communication.

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  • Patients diagnosed with kidney disease are at higher risk for poor visual outcomes.

    “Patients diagnosed with kidney disease, hypertension, and covered under Medicaid insurance are at higher risk for poor visual outcomes13–24.”

    From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [20]

    The Results report that micro- and macroalbuminuria were associated with higher risks of retinopathy and diabetic macular edema, and the Discussion calls albuminuria a strong risk factor for severe diabetic retinopathy. The study concerns patients with type 2 diabetes and measures retinal disease, so it does not establish the broader claim for all patients diagnosed with kidney disease or all poor visual outcomes. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Patients diagnosed with hypertension are at higher risk for poor visual outcomes.

    “Patients diagnosed with kidney disease, hypertension, and covered under Medicaid insurance are at higher risk for poor visual outcomes13–24.”

    From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [20]

    The Results report that blood pressure above 140/80 mmHg was associated with retinopathy and diabetic macular edema in patients with type 2 diabetes; the Discussion describes blood pressure as a risk factor for these complications. The claim is broader: the paper does not establish risk for poor visual outcomes generally or specifically assess patients with a hypertension diagnosis. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Patients covered under Medicaid insurance are at higher risk for poor visual outcomes.

    “Patients diagnosed with kidney disease, hypertension, and covered under Medicaid insurance are at higher risk for poor visual outcomes13–24.”

    From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [20]

    The Results passages identify hypertension and albuminuria as risk factors for retinopathy or diabetic macular edema, but do not address Medicaid coverage. Searches of our copy for Medicaid, insurance coverage, and payer status found no passage linking coverage to visual outcomes. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Authors
Hammes, H.-P., Welp, R., Kempe, H.-P., Wagner, C., Siegel, E., Holl, R. W., & DPV Initiative—German BMBF Competence Network Diabetes Mellitus
Affiliations
  • Heidelberg University (DE)
  • Klinikum Ludwigshafen (DE)
  • St. Josefs Hospital (DE)
  • Universität Ulm (DE)
Corresponding author
Hammes, Hans-Peter
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2015-07-15
Volume
10
Issue
7
Pages
e0132492
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0132492
PMC
PMC4503301
OpenAlex
W1547246386
Cited by
131
References
2
Citations by year
2026: 5 · 2025: 4 · 2024: 16 · 2023: 9 · 2022: 14 · 2021: 14 · 2020: 24 · 2019: 10 · 2018: 13 · 2017: 13 · 2016: 7 · 2015: 2
FWCI
11.22
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • European Foundation for the Study of Diabetes
  • Bundesministerium für Bildung und Forschung (FKZ01GI1106, 01GI1106)
  • Uniklinikum Giessen und Marburg
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
diabetic retinopathy, diabetic macular edema, type 2 diabetes, risk factors, HbA1c, microalbuminuria, macroalbuminuria, hypertension, obesity, diabetic nephropathy, retinopathy prevalence, severe retinopathy
MeSH terms
Aged, Austria, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Female, Germany, Glycated Hemoglobin, Humans, Macular Edema, Male, Risk Factors, Severity of Illness Index, Prevalence, Disease Progression

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