Obesity Not Predictive of Diabetic Retinopathy Progression

The study also shows fewer patients with the condition are progressing than prior research indicated.

For patients with type 2 diabetes, diabetic retinopathy’s prevalence in the United Kingdom has reduced, according to a report published in Diabetes Research and Clinical Practice. The investigation also found that higher HbA1c is predictive of retinopathy development, not obesity. 

The United Kingdom-based research team compared prevalence data collected by the Royal College of General Practitioners Research and Surveillance Centre between 2005 to 2009 and compared it with research from 1998. That comparison shows a drop in retinopathy development among patients with type 2 diabetes from 37% to 19%, the study says. Researchers attribute at least some of this shift to earlier diabetes detection. “It may also be possible that changes in population characteristics and early prescription of ACEi/angiotensin II receptor blockers (ARBs) and HMG-CoA reductase inhibitors (statins) for cardiovascular prevention may also play a role,” the report explains.

After 7 years, 11.6% of participants who had baseline retinopathy progressed. Of the participants with type 2 diabetes who had no baseline retinopathy, 46.4% developed it during the 7-year course of the study. 

The analysis shows no association between total cholesterol and baseline prevalence or progression of retinopathy after diagnosis. Statin use was not associated with either cumulative incidence or progression of retinopathy. In another diversion from previous research, while the 1998 research showed no association between body mass index (BMI) and retinopathy, this study reported a negative association between obesity and retinopathy development at 7 years. 

Obesity (defined as a BMI ≥30 kg/m2) was less likely to be associated with the development of retinopathy than no obesity (BMI <30 kg/m2). It also noted that higher socioeconomic status was statistically protective for both disease development and progression.

“Our observations may suggest that therapies and lifestyle advice, given to the general population for prevention of cardiovascular disease, have the by-product of limiting diabetic retinopathy in incipient Type 2 diabetes mellitus,” according to researchers. “Importantly hyperglycemia remains a key predictor for diabetic retinopathy and its progression.”


Shah S, Feher M, McGovern A, et al. Diabetic retinopathy in newly diagnosed type 2 diabetes mellitus: prevalence and predictors of progression; a national primary network study. Diabetes Res Clin Pract. Published online March 19, 2021. doi:10.1016/j.diabres.2021.108776