Inflammation has long been implicated in the pathogenesis of diabetic retinopathy (DR), but prospective evidence in early-stage type 2 diabetes is limited. A new study presented at EASD 2025, assessed whether systemic inflammatory biomarkers predict DR development or progression.

The study included 3,363 individuals with recently diagnosed type 2 diabetes (median duration 1.1 years; 58% men; median age 61 years). Baseline circulating concentrations of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and soluble CD163 were measured. DR status was obtained via the Danish Registry of Diabetic Retinopathy, and participants were followed for a median of nine years.

During follow-up, new DR developed in 13.9% of participants initially free of retinopathy, and progression occurred in 46.3% of those with baseline DR. Across all biomarkers, no significant associations were observed with baseline DR, incident DR, progression, or the combined endpoint, even after adjustment for glycemic control, renal function, blood pressure, lipids, and medication use.

These findings suggest that systemic low-grade inflammation may not be a reliable predictor of DR in early-stage type 2 diabetes, contrasting with prior cross-sectional studies.