Ocular Complications in Type 2 Diabetes Mellitus Patients with Chronic Kidney Disease: A Retrospective Cohort Study based on the Indonesian National Health Insurance Data

Abstract

The global prevalence of type 2 diabetes mellitus (T2DM) is projected to rise dramatically. Southeast Asia regions will predictably face a 73% increase by 2050, exacerbating risks of microvascular complications like chronic kidney disease (CKD) and ocular disorders. This study aims to investigate the association between ocular comorbidity in type 2 diabetes mellitus (T2DM) patients with a chronic kidney disease (CKD) according to the Indonesian National Health Insurance data. This retrospective cohort study analyzed 7,581 T2DM patients (11.4% with CKD) from Indonesian National Health Insurance (NHI) database year 2016–2023. Odds ratios (OR) and hazard ratios (HR) for ocular diagnoses (ICD-10 codes) were calculated using contingency tables and cox regression after propensity score matching (PSM) for age and sex.  Other retinal disorders (OR: 2.96, 95% CI: 2.22–3.96), vitreous body disorders (OR: 2.92, 95% CI: 2.09–4.08), and other cataracts (OR: 1.70, 95% CI: 1.35–2.13) had significantly higher odds of CKD occurrence in T2DM patients. Conversely, refractive errors showed a lower OR (0.79, 95% CI: 0.64–0.99). Adjusted HRs confirmed elevated risks of CKD in T2DM patients with other retinal disorders (HR: 2.03) and vitreous body disorders (HR: 1.72).  T2DM patients with retinal disorders, vitreous body disorders, globe abnormalities, cataracts, and glaucoma showed markedly higher risks of developing CKD, underscoring the need for integrated screening and management.