Retinopathy in Youth With Type 2 Diabetes Participating in the TODAY Clinical Trial

OBJECTIVE

To determine the prevalence of retinopathy in 517 youth with type 2 diabetes of 2–8 years duration enrolled in the TODAY study.

RESEARCH DESIGN AND METHODS

Retinal photographs were graded centrally for retinopathy using established standards.

RESULTS

Retinopathy was identified in 13.7% of subjects. Prevalence increased with age, diabetes duration, and mean HbA_1c. Subjects in the highest BMI tertile had the lowest prevalence of retinopathy.

CONCLUSIONS

Prevalence of retinopathy and its association with HbA_1c and diabetes duration is similar to that previously reported in youth with type 1 diabetes and in adults with type 2 diabetes of known duration. The mechanism underlying the reduced risk of retinopathy in the most obese individuals is unknown. Follow-up of this cohort will help define the natural history of retinopathy in youth with type 2 diabetes.Characterization of the early course of diabetic retinopathy in adults with type 2 diabetes has been hindered by the long lag time before diagnosis. The TODAY cohort of youth with type 2 diabetes is ideal for examining the prevalence of retinopathy early in the course of the disorder.