Hospital-Based Proportion of Diabetic Retinopathy and Associated Risk Factors Among Patients With Type 2 Diabetes Mellitus

Introduction Diabetic retinopathy (DR) is a leading cause of blindness in individuals with diabetes, and its prevalence is increasing worldwide. This study aimed to explore the relationship between various demographic, clinical, and biochemical factors and the proportion of DR in patients with diabetes at Qassim University Hospital, Qassim, Saudi Arabia. Methods A retrospective cross-sectional study was conducted at Qassim University Hospital, Saudi Arabia, including 370 adult patients with type 2 diabetes mellitus (T2DM). Data were extracted from electronic medical records, including age, gender, duration of diabetes, HbA1c, BMI, comorbidities, medication type, and blood pressure status. Diabetic retinopathy and macular edema were diagnosed based on ophthalmologic evaluation. Statistical analyses included descriptive statistics, Chi-squared tests, independent t-tests, and one-way ANOVA, with significance set at p<0.05. Results A total of 370 patients were included in the study. The mean age of the participants was 55.77 ± 13.98 years, and 54.1% (n=200) were male. The proportion of any diabetic retinopathy was 28.6% (n=106), including 11.6% (n=43) mild non-proliferative diabetic retinopathy (NPDR), 7.8% (n=29) moderate NPDR, 1.9% (n=7) severe NPDR, and 7.3% (n=27) PDR. Macular edema was present in 13.0% (n=48). Patients with DR were significantly older (p<0.001) and had longer diabetes duration (p<0.001) and higher HbA1c (p<0.001) compared with those without DR. Insulin therapy (p<0.001) and hypertension (p=0.024) were also significantly associated with DR. No significant associations were found between DR and comorbidities such as dyslipidemia, hypothyroidism, asthma, BPH, ischemic heart disease, obstructive sleep apnea, chronic kidney disease, or gastrointestinal disorders. ANOVA showed significant differences across DR severity groups for age (p=0.001), duration of diabetes (p<0.001), and HbA1c (p<0.001). Multivariate analysis identified age, duration of diabetes, and HbA1c as independent predictors of diabetic retinopathy (p<0.05). Conclusion Diabetic retinopathy affects nearly one-third of patients with T2DM in this population and is strongly associated with older age, longer disease duration, poor glycemic control, insulin use, and hypertension. These findings highlight the importance of early screening and risk factor management. However, the retrospective design and single-center setting may limit generalizability.