Though most ophthalmologic emphasis has been stressed on the influence of retinopathy on the young diabetic community, lesser known is the complication of cataract, which has resulted in more than half of the blindness worldwide. This study attempts to stratify the epidemiology and risk factors of cataract in the type 1 diabetes mellitus (T1DM) population using data extracted from the National Health Insurance Research Database (NHIRD) in Taiwan.
A two-step study was conducted. For matching on age and gender with the Longitudinal Health Insurance Database (LHID), a total of 3,622 T1DM cases who registered as catastrophic illness patients in Registry between 1998 and 2007 were included for evaluation of epidemiology. For identifying risk factors of cataract in T1DM population, a total of 9,032 T1DM cases who registered between 1998 and 2013 were enrolled, excluding those with pre-T1DM cataract.
Compared to LHID, the hazard ratio (HR) of cataract in T1DM population was 5.81 (95% CI 4.60-7.33) with a higher gender-specific HR in females (6.29, 95% CI 4.63-8.55). In T1DM population, peak incidence of cataract is reached in the 20 to 29 age group compared to the 60+ age group in the LHID population. In the second step of the analysis, half of the eligible T1DM patients were diagnosed before the age of 20 (50.1% in total 9032 patients). The overall incidence of cataract in T1DM group was 9.1% with a higher gender-specific incidence in females (10.4% vs. 7.7%, P < 0.001). T1DM patients with cataract were found to be at a higher rate of accompanying medical conditions, including retinopathy, glaucoma, amputation, and end-stage renal disease than those without cataract (all P < 0.001) .
Cataract seemed to be not only more rampant but also more premature in T1DM patients, especially those of female gender. T1DM patients with cataract presented with higher rates of DM-associated complications which might suggest poor glycemic control to be a predisposing factor.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology