Prevalencia de la retinopatía diabética en la población de diabéticos diagnosticados en las comarcas de Girona: Estudio de los factores asociados

espanolObjetivo: Determinacion de la prevalencia de la retinopatia diabetica en la poblacion general de diabeticos en las comarcas de Girona y estudio epidemiologico de los factores asociados. Metodo: Estudio transversal de base poblacional en una muestra aleatoria de 401 pacientes diabeticos diagnosticados en las comarcas de Girona. Analisis estadistico descriptivo de las lesiones oculares en relacion con la retinopatia diabetica y analisis de regresion logistica para determinacion de los factores de riesgo de la retinopatia. Resultados: El 30,6% (IC 95%: 26,5-35,5) de la muestra presento algun grado de retinopatia diabetica. En estadio inicial el 19,4% (IC 95%: 15,4-24,0), preproliferante el 8,4% (IC 95%: 5,8-1,9) y proliferante el 2,6% (IC 95%: 1,3-5,1). Por tipo de diabetes, el 53,8% de los diabeticos de tipo 1 presentaban retinopatia frente al 34,2% entre los de tipo 2. Se observo retinopatia en un 15,7% de los diabeticos de menos de 10 anos de evolucion de la diabetes, 51,3% entre 10 y 20 anos y 62,8% en mas de 20 anos. La concentracion de HbA1C presento una correlacion significativa con el grado de retinopatia. De los pacientes con retinopatia, el 60,3% recibian tratamiento con insulina, 30,6% con antidiabeticos orales y 10,3% unicamente con dieta. Se encontro mayor prevalencia de retinopatia entre los diabeticos con antecedentes familiares de la misma. Conclusiones: Un tercio de la muestra ha presentado algun grado de retinopatia en este estudio de pacientes diabeticos con base poblacional aleatoria. La prevalencia fue mayor entre los diabeticos de tipo 1. De los factores de riesgo estudiados, el tiempo de evolucion de la enfermedad, el tipo de tratamiento de la diabetes y el grado de control metabolico fueron los factores mas involucrados en la presencia de retinopatia. EnglishPurpose: To determine of the prevalence of diabetic retinopathy in the general diabetic population in the Girona region and epidemiologic study of the related factors. Methods: A population-based cross-sectional study of a randomised sample taken of 401 diabetics in the Girona region. Descriptive statistical analysis of the ocular lesions in relation to diabetic retinopathy and analysis of logistic regression in order to determine the related factors. Results: 30.6% (IC 95%: 26.5-35.5) of the sample presented some degree of diabetic retinopathy, 19.4% (IC 95%: 15.4-24.0) at the initial stage, 8.4% (IC 95%: 5.8-1.9) pre-proliferative and 2.6% (IC 95%: 1.3-5.1) at a proliferative stage. Regarding the type of diabetes, 53% of the patients with type 1 diabetes and 34.2% of those with type 2 diabetes had retinopathy. Retinopathy was observed in 15.7% of diabetics with less than 10 years of diabetes evolution, 51.3% in those between 10 and 20 years and 62.8% in those with more than 20 years. The concentration of HbA1C was significantly associated with the degree of retinopathy. Of those patients with retinopathy, 60.3% were insulin-treated, 30.6% with oral hypoglucemiants and 10.3% on diet only. Patients with family antecedents of retinopathy presented a prevalence three times greater than those without. Conclusions: Approximately one in three diabetic patients exhibited some degree of retinopathy in this study dealing with a population-based cohort of diabetic patients in Spain. The prevalence was greater among type I diabetic patients. As expected, years of evolution of the disease, type of treatment and diabetic metabolic control were the most significant factors influencing the presence of retinopathy.