1：Experimental Design and Method Selection:

A prospective study of patients with type 2 diabetes was conducted in a tertiary eye hospital in Melbourne, Australia. Patients underwent a comprehensive eye examination and completed standardized administered questionnaires. Blood samples were assessed for glycated haemoglobin (HbA1c); fasting blood glucose; and serum lipids. Dilated fundus photographs were obtained and graded for DR and DME. The relative importance of the risk factors was determined by the independent and common variance explained in DR and DME using Commonality analysis.

2：Sample Selection and Data Sources:

English-speaking adults aged 18 years or older with type 1 or type 2 diabetes, free of significant hearing and cognitive impairment, and living independently in the community were invited. Patients were primarily recruited from the Royal Victorian Eye and Ear Hospital (RVEEH).

3：List of Experimental Equipment and Materials:

Two-field 45° digital non-stereo colour fundus photographs of both eyes were taken from each individual using a non-mydriatic retinal camera (Canon CR6 – 45NM), Canon Inc, Japan, with all images being stored electronically using Digital Healthcare software. DR and DME were assessed using dilated fundus photography. Missing data (fundus images) were encountered in 13 cases (

4：5%).DR severity was classified according to the International Clinical Diabetic Retinopathy Severity Scale into:

1) non-proliferative DR (NPDR) and (2) proliferative DR (PDR). NPDR was further grouped into three progressive stages - mild, moderate and severe - with each stage having defined retinal pathologic signs.

5：Experimental Procedures and Operational Workflow:

All examinations were conducted at the Centre for Eye Research Australia (CERA) Melbourne Australia, located at the RVEEH.

6：Data Analysis Methods:

Continuous variables are presented as median (interquartile range [IQR]) for data with skewed distribution and mean (standard deviation [SD]) for normally distributed data, whereas categorical variables are presented as absolute (n) and relative frequencies (%) and 95% confidence interval (95% CI). Differences in continuous variables between participants with and without DR were evaluated by the Mann-Whitney-Wilcoxon test for skewed data, and the t-test for normally distributed data. The proportions between participants with and without DR were compared using the Chi-square test.