糖尿病視網膜病變(diabetic retinopathy, DR)是勞動成年人視力喪失的主要原因。超過三分之一的成年糖尿病病人患有糖尿病視網膜病變，其中三分之一更有高風險進展為可能威脅視力的病變，包括嚴重的非增殖性視網膜病變(non-proliferative diabetic retinopathy, NPDR)、增殖性視網膜病變(proliferative diabetic retinopathy, PDR)或糖尿病黃斑部水腫(diabetic macular edema, DME)。本研究之招募對象為2018年期間年滿18歲參加糖尿病健康促進機構(Diabetes Health Promotion Institutions, DHPI)連續收案5,855名第2型糖尿病病人。排除資訊不完整及不符合條件的對象後，最終符合所有標準的受試者分別有5,100名及5,105名納入視網膜病變及黃斑部水腫的分析。同時蒐集了各項資訊包含收案的醫院層級、年齡、性別、身高、體重、血壓、教育程度、空腹血糖、糖化血色素(A1C)、腎功能，總膽固醇，低密度膽固醇，三酸甘油脂、高密度膽固醇(HDL-C)、胰島素的使用比例，口服血糖藥，高血壓藥，抗血小板藥物的使用比例、糖尿病病程、是否加入糖尿病共同照護網、接受衛教次數、血糖自我監測頻率、低血糖頻率、運動時間、併發症及抽菸狀況。我們發現來自台灣南部和東部地區的人群中有DR和DME的比例較高，該結果可能與醫療保健系統的區域差異有關。我們也注意到年紀較大、高血壓、高血糖以及肌酐酸數值較高的人群中DR和DME的比例也明顯較高，這和過去幾項大型研究的結果相符。而DR和DME的比例在有運動和接受衛教的組別中則明顯較低。此外，我們使用了DN4作為疼痛評分，並發現了其與DR和DME之間的正相關，這是過去未曾研究過的領域。我們的研究再現了許多已知的DR和DME風險因子，同時也顯現了一些尚未被確立或未經研究過的風險因子。由於本研究的橫斷面性質，因此需要進一步的前瞻性研究來證實之中發現的各種相關性。

Diabetic retinopathy (DR) was major cause of blindness in working-age patient. More than one-third adults with diabetes have suffered from diabetic retinopathy, one third of them have high risk of developing vision-threatening DR, including as severe non-proliferative DR (NPDR), proliferative DR (PDR) or progression to diabetic macular edema (DME). There were 5,855 patients enrolled in the Diabetes Health Promotion Institute (DHPI) in 2018 and 5,720 patients with Type 2 diabetes and more than 18 years old were included in our study. We compared hospital information, demographic, laboratory measurement, medication use, health education, exercise situation, and Douleur Neuropathique 4 score between those with and without DR and also those with and without DME. Higher proportion of DR and DME were noted in people from north and east part of Taiwan. The result might be related to the regional difference of health care system. Besides, like the existing worldwide study, we also noted significantly higher proportion of DR and DME in those with older age, higher blood pressure, blood sugar, creatinine level. Exercise and receiving health education were noted with lower proportion of DR and DME. Moreover, we found a positive correlation between DN4 score and DR and DME. Our study showed many known risk factors of DR and DME. Besides, some risk factors that were unclear to DR and DME were also noted in our study. Since our study was a cross-sectional study and further rigorous prospective study is required to confirm the correlation found in it.