Sardarinia M, Asgari S, Arani RH, et al. - The annual occurrence of severe non-proliferative and proliferative diabetic retinopathy (severe-NPDR/PDR) in 1.36% of Iranians with type 2 diabetes mellitus was reported, with independent risk factors being normal bodyweight, being a smoker, out of target fasting plasma glucose level, prehypertension and newly diagnosed hypertension status.

• A total of 1,169 participants (675 women) with type 2 diabetes mellitus, aged ≥20 years, were analyzed.

• Median follow-up of 12.7 years revealed 187 severe-NPDR/PDR cases (126 women); the corresponding incidence rate was 13.6 per 1,000 person-years.

• A lower risk was noted in relation to being overweight and obese, whereas increased risk of severe-NPDR/PDR was evident in relation to being smoker, having fasting plasma glucose levels 7.22–10.0 mmol/L, fasting plasma glucose ≥10 mmol/L, taking glucose-lowering medications, prehypertension status and newly diagnosed hypertension.

• In newly diagnosed diabetes, a 59% lower risk of severe-NPDR/PDR was observed in relation to being male.

• A higher risk of developing PDR was noted in patients with an intermediate level of education (6–12 years) vs those who had <6 years of education.

• Multicomponent strategy to control diabetes, abstinence of smoking and tight control of blood pressure merit consideration.