Lipid‐lowering medication is associated with decreased risk of diabetic retinopathy and the need for treatment in patients with type 2 diabetes: A real‐world observational analysis of a health claims database

摘要

Aims Fenofibrate and statins reduced the need for diabetic retinopathy (DR)‐related treatment in clinical trials. We aimed to determine whether use of lipid‐lowering medication reduces the risk of DR and the need for treatment in patients with type 2 diabetes using a real‐world health claims database. Methods This was an observational analysis using a nation‐wide health claims database of the Japan Medical Data Center (JMDC). Type 2 diabetes was defined according to ICD‐10 codes for use of glucose‐lowering medication. Use of lipid‐lowering medication for at least 1 year was confirmed by the Anatomical Therapeutic Chemical Classification System. DR and diabetic macular edema (DME) were determined by ICD‐10 codes. DR‐related treatments were determined by health insurance claims. A propensity score for use of lipid‐lowering medication was estimated, and a doubly robust estimator, using the inverse probability weighting model with regression adjustment, was obtained to determine odds ratios (OR) with 95% confidence interval (95% CI) for cumulative incidence of DR and its treatments over 3 years. Results There were 69 070 individuals with type 2 diabetes at baseline, among whom DR developed in 5687 over a period of 3 years. Use of lipid‐lowering medication was associated with decreased risk of incidence of DR (OR, 0.772; 95% CI, 0.720‐0.827; P .001). Use of lipid‐lowering medication was also associated with decreased incidence of DME, any treatments for DR, laser photocoagulation and vitrectomy in patients with DR at baseline. Conclusions In a population of patients with type 2 diabetes with a variety of risk profiles, use of lipid‐lowering medication reduced the risk of DR and thus the risks involved in treatment with laser photocoagulation and vitrectomy.