Incidence and Determinants of Intraocular Lens Implantation in Type 2 Diabetes: The Fremantle Diabetes Study Phase II

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Abstract

OBJECTIVETo compare the incidence of intraocular lens (IOL) implantation for cataracts between people with and without type 2 diabetes and to determine associated risk factors in those with type 2 diabetes.RESEARCH DESIGN AND METHODSParticipants with type 2 diabetes (n = 1,499) from the community-based observational Fremantle Diabetes Study Phase II (FDS2) were age, sex, and zip code matched 1:4 with residents without diabetes. IOL implantation status was ascertained between entry (2008-2011) and the end of 2016 using validated data linkage. Age-specific incidence rates and incidence rate ratios (IRRs) for cataract surgery were calculated. Predictors of IOL implantation in FDS2 participants were assessed using proportional hazards and competing risk regression modeling.RESULTSThe crude IRR (95% CI) for cataract surgery in FDS2 participants (mean SD age 62.8 +/- 10.8 years at entry) versus the matched group without diabetes was 1.50 (1.32-1.71), with the highest relative risk in those aged 45-54 years at the time of surgery (7.12 [2.05-27.66]). Competing risk analysis showed that age at entry, diabetes duration, serum HDL cholesterol, serum triglycerides, a severe hypoglycemic episode in the past year, and Asian and southern European ethnicity increased the risk of cataract surgery in participants with type 2 diabetes (P 0.025).CONCLUSIONSPeople with type 2 diabetes, especially those in younger age-groups, are at a significantly increased risk of cataract surgery than matched people without diabetes. Multifaceted prevention strategies should be incorporated as part of routine care. As well as limiting ultraviolet light exposure, these might include lipid-modifying treatment and strategies to avoid severe hypoglycemia.

Original languageEnglish
Pages (from-to)288-296
Number of pages9
JournalDiabetes Care
Volume42
Issue number2
DOIs
Publication statusPublished - 1 Feb 2019

Cite this

@article{df021036fee5402aa5a5543963042acf,
title = "Incidence and Determinants of Intraocular Lens Implantation in Type 2 Diabetes: The Fremantle Diabetes Study Phase II",
abstract = "OBJECTIVETo compare the incidence of intraocular lens (IOL) implantation for cataracts between people with and without type 2 diabetes and to determine associated risk factors in those with type 2 diabetes.RESEARCH DESIGN AND METHODSParticipants with type 2 diabetes (n = 1,499) from the community-based observational Fremantle Diabetes Study Phase II (FDS2) were age, sex, and zip code matched 1:4 with residents without diabetes. IOL implantation status was ascertained between entry (2008-2011) and the end of 2016 using validated data linkage. Age-specific incidence rates and incidence rate ratios (IRRs) for cataract surgery were calculated. Predictors of IOL implantation in FDS2 participants were assessed using proportional hazards and competing risk regression modeling.RESULTSThe crude IRR (95{\%} CI) for cataract surgery in FDS2 participants (mean SD age 62.8 +/- 10.8 years at entry) versus the matched group without diabetes was 1.50 (1.32-1.71), with the highest relative risk in those aged 45-54 years at the time of surgery (7.12 [2.05-27.66]). Competing risk analysis showed that age at entry, diabetes duration, serum HDL cholesterol, serum triglycerides, a severe hypoglycemic episode in the past year, and Asian and southern European ethnicity increased the risk of cataract surgery in participants with type 2 diabetes (P 0.025).CONCLUSIONSPeople with type 2 diabetes, especially those in younger age-groups, are at a significantly increased risk of cataract surgery than matched people without diabetes. Multifaceted prevention strategies should be incorporated as part of routine care. As well as limiting ultraviolet light exposure, these might include lipid-modifying treatment and strategies to avoid severe hypoglycemia.",
keywords = "AGE-RELATED CATARACT, HIGH-DENSITY-LIPOPROTEIN, DISEASE RISK-FACTORS, CARDIOVASCULAR-DISEASE, MICROVASCULAR COMPLICATIONS, INCIDENCE RATES, PREVALENCE, SURGERY, ASSOCIATION, PROGRESSION",
author = "Drinkwater, {Jocelyn J.} and Davis, {Timothy M. E.} and Turner, {Angus W.} and Bruce, {David G.} and Davis, {Wendy A.}",
year = "2019",
month = "2",
day = "1",
doi = "10.2337/dc18-1556",
language = "English",
volume = "42",
pages = "288--296",
journal = "Diabetes Care",
issn = "0149-5992",
publisher = "American Diabetes Association",
number = "2",

}

TY - JOUR

T1 - Incidence and Determinants of Intraocular Lens Implantation in Type 2 Diabetes

T2 - The Fremantle Diabetes Study Phase II

AU - Drinkwater, Jocelyn J.

AU - Davis, Timothy M. E.

AU - Turner, Angus W.

AU - Bruce, David G.

AU - Davis, Wendy A.

PY - 2019/2/1

Y1 - 2019/2/1

N2 - OBJECTIVETo compare the incidence of intraocular lens (IOL) implantation for cataracts between people with and without type 2 diabetes and to determine associated risk factors in those with type 2 diabetes.RESEARCH DESIGN AND METHODSParticipants with type 2 diabetes (n = 1,499) from the community-based observational Fremantle Diabetes Study Phase II (FDS2) were age, sex, and zip code matched 1:4 with residents without diabetes. IOL implantation status was ascertained between entry (2008-2011) and the end of 2016 using validated data linkage. Age-specific incidence rates and incidence rate ratios (IRRs) for cataract surgery were calculated. Predictors of IOL implantation in FDS2 participants were assessed using proportional hazards and competing risk regression modeling.RESULTSThe crude IRR (95% CI) for cataract surgery in FDS2 participants (mean SD age 62.8 +/- 10.8 years at entry) versus the matched group without diabetes was 1.50 (1.32-1.71), with the highest relative risk in those aged 45-54 years at the time of surgery (7.12 [2.05-27.66]). Competing risk analysis showed that age at entry, diabetes duration, serum HDL cholesterol, serum triglycerides, a severe hypoglycemic episode in the past year, and Asian and southern European ethnicity increased the risk of cataract surgery in participants with type 2 diabetes (P 0.025).CONCLUSIONSPeople with type 2 diabetes, especially those in younger age-groups, are at a significantly increased risk of cataract surgery than matched people without diabetes. Multifaceted prevention strategies should be incorporated as part of routine care. As well as limiting ultraviolet light exposure, these might include lipid-modifying treatment and strategies to avoid severe hypoglycemia.

AB - OBJECTIVETo compare the incidence of intraocular lens (IOL) implantation for cataracts between people with and without type 2 diabetes and to determine associated risk factors in those with type 2 diabetes.RESEARCH DESIGN AND METHODSParticipants with type 2 diabetes (n = 1,499) from the community-based observational Fremantle Diabetes Study Phase II (FDS2) were age, sex, and zip code matched 1:4 with residents without diabetes. IOL implantation status was ascertained between entry (2008-2011) and the end of 2016 using validated data linkage. Age-specific incidence rates and incidence rate ratios (IRRs) for cataract surgery were calculated. Predictors of IOL implantation in FDS2 participants were assessed using proportional hazards and competing risk regression modeling.RESULTSThe crude IRR (95% CI) for cataract surgery in FDS2 participants (mean SD age 62.8 +/- 10.8 years at entry) versus the matched group without diabetes was 1.50 (1.32-1.71), with the highest relative risk in those aged 45-54 years at the time of surgery (7.12 [2.05-27.66]). Competing risk analysis showed that age at entry, diabetes duration, serum HDL cholesterol, serum triglycerides, a severe hypoglycemic episode in the past year, and Asian and southern European ethnicity increased the risk of cataract surgery in participants with type 2 diabetes (P 0.025).CONCLUSIONSPeople with type 2 diabetes, especially those in younger age-groups, are at a significantly increased risk of cataract surgery than matched people without diabetes. Multifaceted prevention strategies should be incorporated as part of routine care. As well as limiting ultraviolet light exposure, these might include lipid-modifying treatment and strategies to avoid severe hypoglycemia.

KW - AGE-RELATED CATARACT

KW - HIGH-DENSITY-LIPOPROTEIN

KW - DISEASE RISK-FACTORS

KW - CARDIOVASCULAR-DISEASE

KW - MICROVASCULAR COMPLICATIONS

KW - INCIDENCE RATES

KW - PREVALENCE

KW - SURGERY

KW - ASSOCIATION

KW - PROGRESSION

U2 - 10.2337/dc18-1556

DO - 10.2337/dc18-1556

M3 - Article

VL - 42

SP - 288

EP - 296

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 2

ER -