Regional analysis of diabetic retinopathy and co-existing social and demographic factors in the overall population of Poland

INTRODUCTION: The aim of our study was to analyse the regional differences in diabetic retinopathy (DR) prevalence and its co-existing social and demographic factors in the overall population of Poland in the year 2017. MATERIAL AND METHODS: Data from all levels of healthcare services at public and private institutions recorded in the National Health Fund database were evaluated. International Classification of Diseases codes were used to identify patients with type 1 and type 2 diabetes mellitus (DM) and with DR. Moran’s I statistics and Spatial Autoregressive (SAR) model allowed us to understand the distribution of DR prevalence and its possible association with environmental and demographic exposures. RESULTS: In total, 310,815 individuals with diabetic retinopathy (DR) were diagnosed in the year 2017 in Poland. Of them, 174,384 (56.11%) were women, 221,144 (71.15%) lived in urban areas, and 40,231 (12.94%) and 270,584 (87.06%) had type 1 and type 2 DM, respectively. The analysis of the SAR model showed that the significant factors for the occurrence of DR in particular counties were a higher level of average income and a higher number of ophthalmologic consultations per 10,000 adults. CONCLUSIONS: The analyses of social, demographic, and systemic factors co-existing with DR revealed that level of income and access to ophthalmologic and diabetic services are crucial in DR prevalence in Poland.