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Fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system, with DR defined as typical lesions of DR (microaneurysms, exudates, hemorrhage, or worse) in either eye.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>By DPPOS year 16 (\u223c20 years after random assignment into DPP), 24% of 1,614 participants who had developed T2D and 14% of 885 who remained without diabetes had DR. In univariate analyses, using results from across the entire duration of follow-up, American Indian race was associated with less frequent DR compared with non-Hispanic White (NHW) race, and higher HbA1c, fasting and 2-h plasma glucose levels during an oral glucose tolerance test, weight, and history of hypertension, dyslipidemia, and smoking, but not treatment group assignment, were associated with more frequent DR. On multivariate analysis, American Indian race was associated with less DR compared with NHW (odds ratio [OR] 0.36, 95% CI 0.20\u20130.66), and average HbA1c was associated with more DR (OR 1.92, 95% CI 1.46\u20131.74 per SD [0.7%] increase in HbA1c).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>DR may occur in adults with prediabetes and early in the course of T2D. HbA1c was an important risk factor for the development of DR across the entire glycemic range from prediabetes to T2D.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc22-0860","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T10:20:52Z","timestamp":1663064452000},"page":"2653-2661","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":30,"title":["Risk Factors for the Development of Retinopathy in Prediabetes and Type 2 Diabetes: The Diabetes Prevention Program Experience"],"prefix":"10.2337","volume":"45","author":[{"given":"Neil H.","family":"White","sequence":"first","affiliation":[{"name":"1Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Pan","sequence":"additional","affiliation":[{"name":"2The Biostatistics Center, Milken Institute School of Public 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