Full Title: Association Between Blood Glucose-Related Indicators and Diabetic Retinopathy in Type 2 Diabetes: A Cross-Sectional Study

Objectives: To investigate the prevalence of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and to analyze the association between blood glucose-related indicators and the occurrence of DR. Methods: A cross-sectional study was conducted among hospital-based patients with T2DM. Participants were categorized into DR and non-diabetic retinopathy (NDR) groups based on fundus photography examinations. Data on demographic characteristics, lifestyle factors, and blood glucose-related indicators were collected. Univariate and multivariable logistic regression analyses were employed to examine the associations between these factors and DR in T2DM patients. Results: Among 5,498 patients with T2DM, 1,144 (20.81%) were diagnosed with DR. Univariate analysis revealed significant associations between DR and diagnosis age of T2DM, duration of T2DM, HbA1c, heart rate, smoking history, daily fruit consumption, and daily soy-products consumption (P<0.05). After adjusting for age, sex, and lifestyle factors, multivariable logistic regression demonstrated independent associations with DR for the following factors: diagnosis age of T2DM (OR: 0.543, 95%CI: 0.414-0.731), duration of T2DM (1-5 years: OR: 1.713, 95%CI: 1.416-2.073; 5-10 years: OR: 2.516, 95%CI: 2.012-3.145; ≥10 years: OR: 4.659, 95%CI: 3.748-5.790), HbA1c (OR: 1.111, 95%CI: 1.069-1.154), and heart rate (OR: 1.008, 95%CI: 1.003-1.014) (P<0.05). Conclusions: The prevalence of DR among T2DM patients was 20.81%, with non-proliferative diabetic retinopathy (NPDR) being the predominant type, accounting for 96.85% of cases. Elevated HbA1c levels, longer duration of T2DM, younger age at diagnosis of T2DM, and increased heart rate were identified as independent risk factors for DR.