ArticleDiabetes care2025
The Role of Urban Residence, Race and Ethnicity, and Glycemic Control in Receiving Standards of Care and Progression to Vision-Threatening Diabetic Retinopathy.
Article in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
3 citing papers in PubMed.
- Social Determinants of Diabetic Retinopathy Severity at Initial Presentation: A Cross-Sectional Study of Data from an Urban Safety Net Hospital.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
- The Impact of African Caribbean Heritage on the Development of Sight-Threatening Diabetic Retinopathy in a Multiethnic Cohort of People With Type 2 Diabetes.Diabetes care · 2025Article
- Artificial Intelligence Improves Patient Follow-Up in a Diabetic Retinopathy Screening Program [Letter].Clinical ophthalmology (Auckland, N.Z.) · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveAmong patients with diabetes living in the U.S. with newly detected mild or moderate nonproliferative diabetic retinopathy (NPDR) without diabetic macular edema (DME), we aimed to characterize determinants for receiving standards of care and progression to vision-threatening diabetic retinopathy (VTDR) (severe NPDR, proliferative diabetic retinopathy, DME). RESEARCH DESIGN AND
methodsElectronic health records of patients newly detected with NPDR without DME between 2015 and 2023 were analyzed with use of the Epic Cosmos research platform. We characterized the adjusted associations of urban versus rural residence, race and ethnicity (Hispanic, non-Hispanic [NH] White, NH Black, other), and glycemic control (HbA1c <7.0%, 7.0%-8.9%, ≥9%, unavailable) separately with guideline-recommended care (two of three: ophthalmology visit, primary care visit, and measurement of HbA1c, blood pressure, and LDL cholesterol) in the 2 years after diagnosis and with progression to VTDR.
resultsAverage (SD) age for the analytic sample (n = 102,919) was 63 (13.5) years, and 51% were female, 59% NH White, and 7% rural residents. Only 40% received guideline-recommended care, and 14% progressed to VTDR (median follow-up 35 months [interquartile range 18-63]). Urban residence was associated with receiving standards of care in both years (risk ratio 1.08 [95% CI 1.05-1.12]) and progression to VTDR (hazard ratio 1.07 [95% CI 0.99-1.15]). Racial and ethnic minority individulas were more likely to progress to VTDR. Individuals with poor or unknown glycemic control were less likely to receive standards of care and more likely to progress to VTDR.
conclusionsUnderstanding the management and progression of newly detected NPDR will require disentangling the independent and interdependent contributions of geography, race and ethnicity, and glycemia.
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