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The following is a summary of “Stroke incidence increases with diabetic retinopathy severity and macular edema in type 1 diabetes,” published in the April 2024 issue of Cardiology by Eriksson et al.
As the retina is suggested to mirror the brain, diabetic retinopathy and macular edema might signal stroke risk in type 1 diabetes.
Researchers conducted a retrospective study to investigate the link between individuals and type 1 diabetes to see if these eye conditions predict stroke risk.
They used 1,268 adults with type 1 diabetes from the FinnDiane Study with age 38.7±11.8 years, consisting of 51.7% men and 48.3% women, with 31.5% having diabetic kidney disease. Participants had baseline diabetic retinopathy graded by the Early Treatment Diabetic Retinopathy Study (ETDRS) scale, and macular edema, as clinically significant (CSME) or not, were monitored for strokes. They used Cox models to calculate the hazard ratio (HR) for stroke risk based on retinopathy severity and macular edema, adjusting for clinical factors including diabetic kidney disease.
The results showed that during 18.0 years of median follow-up, 130 strokes (96 ischemic, 34 hemorrhagic) were observed. Compared to those with minimal retinopathy (ETDRS 10-20), the risk of stroke was higher 1.79 (95% CI, 1.02-3.15) in non-proliferative (ETDRS 35-53) and 1.69 (1.02 – 2.82) in proliferative (ETDRS 61-85) retinopathy groups. The risk for ischemic stroke was 1.68 (0.91-3.10) in non-proliferative and 1.35 (0.77-2.36) in proliferative retinopathy. The risk was significantly elevated for hemorrhagic stroke in the proliferative retinopathy group (4.31 [1.16-16.10] vs. 2.84 [0.66-12.28]). However, CSME did not increase HR for any stroke type after adjustment for clinical confounders.
Investigators concluded that more severe diabetic retinopathy predicts higher stroke risk, regardless of other health conditions like diabetic kidney disease.
Source: cardiab.biomedcentral.com/articles/10.1186/s12933-024-02235-w