{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T09:55:05Z","timestamp":1778752505330,"version":"3.51.4"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp;amp; Metabol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Although risk factors linked to diabetic retinopathy (DR) among patients with Type 2 diabetes mellitus (T2DM) have been extensively studied globally, the specific determinants of these factors in relation to DR in Palestine are presently not well understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cross\u2010sectional study included patients who underwent DR screening with a fundus camera (VersaCam <jats:italic>a<\/jats:italic>). The study included patients aged \u226518 with T2DM, excluding those with other types of diabetes or a history of malignancies. Univariable and multivariable logistic regressions were used to identify factors associated with DR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1163 patients with T2DM were included in this study. Of these, 211 (18.1%) patients were classified in the DR group, 761 (65.4%) in the no DR group and 191 (16.4%) were ungradable. Among the included patients, 434 (37.3%) were male. A secondary level of education or higher and a BMI \u226530\u2009kg\/m<jats:sup>2<\/jats:sup>, compared with &lt;25\u2009kg\/m<jats:sup>2<\/jats:sup>, were independently and inversely associated with DR, with odds ratios (ORs) of 0.46 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and 0.58 (<jats:italic>p<\/jats:italic>\u2009=\u20090.046), respectively. A 5\u2010year increase in the duration of T2DM correlated with 45% higher odds of having DR (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Patients with DR were more likely to have HbA1c &gt;7%, be physically inactive and use insulin, with ORs of 1.63 (<jats:italic>p<\/jats:italic>\u2009=\u20090.02), 2.05 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and 1.53 (<jats:italic>p<\/jats:italic>\u2009=\u20090.03), respectively. Age, gender, occupational status, hypertension and hyperlipidaemia were not independent predictors of DR (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Longer duration of T2DM, HbA1c &gt;7%, physical inactivity and insulin use were all independently associated with the presence of DR. Furthermore, a secondary or higher educational level and obesity demonstrated independent and inverse associations with the development of DR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/edm2.494","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T11:56:05Z","timestamp":1718366165000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Identification of Risk Factors for the Development of Diabetic Retinopathy Among Palestinian Adults With Type 2 Diabetes Mellitus: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7532-1544","authenticated-orcid":false,"given":"Oadi\u00a0N.","family":"Shrateh","sequence":"first","affiliation":[{"name":"Faculty of Medicine Al\u2010Quds University  Jerusalem 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