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Glycemic control is an important modifiable risk factor for uveitis in patients with diabetes: A retrospective cohort study establishing clinical risk and ophthalmic disease burden.

Ansari, Samad, de Lusignan, Simon, Hinton, William, Munro, N, Taylor, Simon and Mcgovern, Andrew Peter (2018) Glycemic control is an important modifiable risk factor for uveitis in patients with diabetes: A retrospective cohort study establishing clinical risk and ophthalmic disease burden. Journal of Diabetes and Its Complications, 32 (6). pp. 602-608.

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[Paper] uveitis scleritis and glycaemia.pdf - Accepted version Manuscript
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Abstract

Aim To characterize the risk uveitis, scleritis or episcleritis in relation to diabetes, glycaemic control, and co-existence of retinopathy. Methods Using the Royal College of General Practitioners Research and Surveillance Centre database, we established the prevalence of acute uveitis and scleritis or episcleritis over a six-year period among populations without(n = 889,856) and with diabetes(n = 48,584). We evaluated the impact of glycaemic control on disease risk. Regression modeling was used to identify associations, adjusting for clinical and demographic confounders. Results Incidence of acute uveitis was higher among patients with diabetes; Type 1 OR:2.01 (95% CI 1.18–3.41; p = 0.009), and Type 2 OR:1.23 (1.05–1.44; p = 0.01). Glycaemic control was established as an important effect modifier for uveitis risk, whereby those with poorer control suffered higher disease burden. Results confirmed a dose-response relationship such that very poor glycaemic control OR:4.72 (2.58–8.65; p < 0.001), poor control OR:1.57 (1.05–2.33; p = 0.03) and moderate control OR:1.20 (0.86–1.68; p = 0.29) were predictive of uveitis. Similar results were observed when evaluating retinopathy staging: proliferative retinopathy OR:2.42 (1.25–4.69; p = 0.01). These results were not maintained for scleritis or episcleritis. Conclusion Acute uveitis is more common in patients with diabetes; at highest risk are those with type 1 disease with poor glycaemic control. Glycaemic improvements may prevent recurrence.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Ansari, Samads.ansari@surrey.ac.uk
de Lusignan, SimonS.Lusignan@surrey.ac.uk
Hinton, Williamw.hinton@surrey.ac.uk
Munro, N
Taylor, Simons.r.taylor@surrey.ac.uk
Mcgovern, Andrew Petera.p.mcgovern@surrey.ac.uk
Date : 23 March 2018
Identification Number : 10.1016/j.jdiacomp.2018.03.008
Copyright Disclaimer : © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Depositing User : Melanie Hughes
Date Deposited : 20 Mar 2018 12:02
Last Modified : 10 Jul 2018 13:45
URI: http://epubs.surrey.ac.uk/id/eprint/846052

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