TY - JOUR
T1 - Association of continuous subcutaneous insulin therapy and diabetic retinopathy in type 1 diabetes
T2 - A national cohort study
AU - Thykjær, Anne S.
AU - Rosengaard, Louise
AU - Andersen, Nis
AU - Andresen, Jens
AU - Hajari, Javad
AU - Heegaard, Steffen
AU - Højlund, Kurt
AU - Kawasaki, Ryo
AU - Laugesen, Caroline S.
AU - Möller, Sören
AU - Pedersen, Frederik N.
AU - Schielke, Katja
AU - Stokholm, Lonny M.
AU - Grauslund, Jakob
PY - 2024/9
Y1 - 2024/9
N2 - Aim: This study aimed to investigate the short-and long-term effect on diabetic retinopathy (DR) in individuals with type 1 diabetes treated with continuous subcutaneous insulin injections (CSII) compared to those using multiple daily injections (MDI). Methods: We conducted a register-based matched cohort study utilizing data from the Danish Registry of Diabetic Retinopathy as well as several other national Danish health registers. Our cohort consisted of all individuals with type 1 diabetes who attended the Danish screening program for DR from 2013 to 2022. We included individuals registered with CSII treatment, and compared them to individuals using MDI, matched by age, sex, and DR level. Cox regression analysis was performed to evaluate the outcomes. Results: The study included 674 individuals treated with CSII and 2006 matched MDI users. In our cohort 53.4 % were female and median age was 36 (IQR 27–47). Average follow-up risk-time was 4.8 years. There was no difference in the risk of DR worsening between the CSII group and MDI group (HR 1.05 [95%CI 0.91; 1.22], p = 0.49). However, an increased risk of focal photocoagulation was observed in the CSII group (HR 2.40 [95%CI 1.11; 5.19], p = 0.03). Conclusions: Our findings indicate that CSII treatment does not confer a significant difference in the overall short- and long-term risk of DR worsening or ocular intervention compared to MDI treatment. These results provide insights into the DR outcomes of CSII treatment in individuals with type 1 diabetes.
AB - Aim: This study aimed to investigate the short-and long-term effect on diabetic retinopathy (DR) in individuals with type 1 diabetes treated with continuous subcutaneous insulin injections (CSII) compared to those using multiple daily injections (MDI). Methods: We conducted a register-based matched cohort study utilizing data from the Danish Registry of Diabetic Retinopathy as well as several other national Danish health registers. Our cohort consisted of all individuals with type 1 diabetes who attended the Danish screening program for DR from 2013 to 2022. We included individuals registered with CSII treatment, and compared them to individuals using MDI, matched by age, sex, and DR level. Cox regression analysis was performed to evaluate the outcomes. Results: The study included 674 individuals treated with CSII and 2006 matched MDI users. In our cohort 53.4 % were female and median age was 36 (IQR 27–47). Average follow-up risk-time was 4.8 years. There was no difference in the risk of DR worsening between the CSII group and MDI group (HR 1.05 [95%CI 0.91; 1.22], p = 0.49). However, an increased risk of focal photocoagulation was observed in the CSII group (HR 2.40 [95%CI 1.11; 5.19], p = 0.03). Conclusions: Our findings indicate that CSII treatment does not confer a significant difference in the overall short- and long-term risk of DR worsening or ocular intervention compared to MDI treatment. These results provide insights into the DR outcomes of CSII treatment in individuals with type 1 diabetes.
KW - Continuous subcutaneous insulin injections
KW - Diabetic retinopathy
KW - Incidence
KW - Long-term
KW - Multiple daily injections
KW - Progression
U2 - 10.1016/j.jdiacomp.2024.108830
DO - 10.1016/j.jdiacomp.2024.108830
M3 - Journal article
C2 - 39096767
AN - SCOPUS:85200159803
SN - 1056-8727
VL - 38
JO - Journal of Diabetes and Its Complications
JF - Journal of Diabetes and Its Complications
IS - 9
M1 - 108830
ER -