Prevalence and Associated Risk Factors of Diabetic Retinopathy in Patients with Diabetes Mellitus at A Tertiary Care Hospital of North Bengal, Bangladesh

Background: Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM) and a leading cause of visual impairment. Identifying its prevalence and associated risk factors is essential for timely intervention. Objectives: To determine the prevalence of diabetic retinopathy and identify associated risk factors among patients with diabetes mellitus attending a tertiary care hospital of North Bengal (Rangpur Division), Bangladesh. Methods & Materials: A hospital-based cross-sectional study was conducted among 362 adult patients with type 1 or type 2 diabetes from January 2024 to June 2025. Data were collected using structured interviews, medical records, clinical measurements, and ophthalmic examinations. Diabetic retinopathy was graded using ICDR/ETDRS scales. Multivariable logistic regression was performed to identify independent risk factors for DR. Results: The mean age of participants was 52.3 ± 11.6 years; 54% were male and 46% female. Type 2 diabetes predominated (89%). The mean duration of diabetes was 8.7 ± 6.2 years, and mean HbA1c was 8.1 ± 1.9%. The prevalence of DR was 32.6%, with mild non-proliferative DR being most common (16.3%). Multivariable analysis identified duration of diabetes ≥10 years (AOR = 3.4, 95% CI: 2.0–5.7), HbA1c ≥7% (AOR = 2.8, 95% CI: 1.7–4.6), hypertension (AOR = 1.9, 95% CI: 1.1–3.3), and smoking (AOR = 1.6, 95% CI: 1.0–2.7) as independent risk factors for DR. Age, gender, BMI, and dyslipidemia were not significantly associated. Conclusions: Approximately one-third of diabetic patients had DR. Longer diabetes duration, poor glycemic control, hypertension, and smoking were key modifiable risk factors. Regular retinal screening, optimal glycemic and blood pressure management, and lifestyle interventions, particularly smoking cessation, are recommended to prevent DR progression and preserve vision.