Several Influential Risk Factors for Diabetic Retinopathy Among Productive-Age Patients With Type 2 Diabetes Mellitus at Dr. Kariadi Central General Hospital Semarang: A Case–Control Study

Abstract

Diabetic retinopathy is a chronic microvascular complication of type 2 diabetes mellitus and a major cause of visual impairment, particularly affecting individuals in the productive age group. This study aimed to analyze risk factors associated with diabetic retinopathy among productive-age patients with type 2 diabetes mellitus at Dr. Kariadi General Hospital Semarang. A case control study was conducted involving 68 cases and 68 controls. Data were collected through electronic medical records and patient interviews. Bivariate analysis showed significant associations associations (p < 0.05) age 45–59 years (p  0.000; OR = 4.091), non-adherence to dietary recommendations (p  0.000; OR = 7.547), duration of diabetes ≥ 10 years (p = 0.016; OR = 2.457), hypertension (p  0.000; OR = 4.339), non-adherence to medication (p = 0.025; OR = 2.322), and HbA1c levels ≥6.5% (p 0.000; OR = 7.869). Meanwhile, physical activity, and obesity did not show significant associations (p > 0.05). Multivariate analysis identified significant predictors including age 45–59 years (p = 0.002; OR = 5.028), non-adherence to diet (p < 0.001; OR = 13.900), diabetes duration ≥10 years (p = 0.030; OR = 3.114), hypertension (p = 0.049; OR = 2.776), non-adherence to medication (p = 0.011; OR = 3.793), and HbA1c ≥6.5% (p < 0.001; OR = 11.278). The strongest predictors were poor dietary adherence and elevated HbA1c. Key risk factors for diabetic retinopathy in productive age patients include non adherence to dietary recommendations, high HbA1c levels, older age (45–59 years), longer diabetes duration, hypertension, and medication non-adherence. Strengthening dietary compliance, glycemic control, and regular HbA1c monitoring is essential to prevent or delay retinopathy progression.