The most frequent vision-threatening side effect of diabetic retinopathy, DME has a major negative influence on quality of life. T1D data is still scarce, limiting focused prevention and therapy, whereas T2D data has been well investigated. Given that people with T1D are living longer, it is essential to comprehend its unique risk profile in order to improve screening and treatment recommendations. The frequency, natural history, clinical risk factors, and unique features of diabetic macular edema in type 1 diabetes mellitus are examined in this study, with particular attention to similarities with type 2 diabetes mellitus.
Following PRISMA principles, this systematic review and meta-analysis was conducted and. On July 15, 2024, a thorough literature search was conducted using the MedLine (via PubMed), Scopus, and Web of Science databases. Original observational studies that specifically reported the prevalence, natural history, incidence, or risk factors of DME in T1D patients were among the studies that qualified. NIH criteria were used to evaluate the risk of bias.
27 of the 63 included studies, which comprised 20,074 patients and 40 different study populations, qualified for meta-analysis. In those with T1D, the combined frequency of DME was 11.1% (95% CI: 7.9-14.3%, I2=99.6%). The adjusted prevalence was 14.8% at the sample means (19.9 years of diabetes; HbA1c 8.6%), which were determined by meta-regression to be significant predictors of illness duration and HbA1c.
On average, prevalence rose by 4.7 percentage points for every 1% increase in HbA1c and 1.2 percentage points for every extra year of illness. Higher DME prevalence was also linked to other variables as nephropathy, dyslipidemia, and hypertension. Using the GRADE method, the evidence's level of certainty was assessed as extremely poor.
Overall, the occurrence of DME in T1D is high and strongly correlated with glycemic management and the length of the disease. Future studies should concentrate on improving diagnostic standards, including new biomarkers, and assessing the effects of cutting-edge diabetic care devices.
Source:
Marques-Couto, P., Afonso, J., Coelho-Costa, I., Neves, J. S., Falcão, M., & Laiginhas, R. (2025). Prevalence and risk factors of diabetic macular edema in type 1 diabetes: A systematic review and meta-analysis. Ophthalmology Retina. https://doi.org/10.1016/j.oret.2025.09.008
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