This study shows that the prevalence of diabetic retinopathy is lower in urban South Indians than in other ethnic groups. However, due to the large number of diabetic subjects, DR is likely to pose a public health burden in India; hence, routine retinal examination is mandatory to detect DR in the early stages.

Objective-The aim of this study was to determine the prevalence and risk factors for microalbuminuria among south Indian type 2 diabetic patients attending a diabetes centre. Methods-One thousand four hundred and twenty five type 2 diabetic patients attending a diabetes centre in south India were recruited for the study. Urinary albumin concentration was measured by immunoturbodimetric assay. Microalbuminuria was diagnosed if the urinary albumin excretion was >30 mg/g of creatinine. Results-Overall prevalence of microalbuminuria was 36.3% (95% confidence interval 33.8 to 38.9). The prevalence of microalbuminuria increased with the increase in duration of diabetes. Multivariate regression analysis revealed age, diastolic blood pressure, glycated haemoglobin, fasting plasma glucose, and duration of diabetes to be associated with microalbuminuria. Conclusion-The overall prevalence of microalbuminuria in this south Indian clinic population and its risk factors are similar to that reported in Europeans. (Postgrad Med J 2001;77:399-402)

1. This study was conducted on 467 cases of non-insulin-dependent diabetes mellitus and 180 healthy controls. Lipid peroxidation products in plasma and erythrocytes were assayed as thiobarbituric acid reactive substances, along with the erythrocyte antioxidant enzymes, namely superoxide dismutase, catalase and glutathione peroxidase. In addition, scavenger vitamins A, C and E and reduced glutathione levels in blood were also measured. 2. Lipid peroxidation was significantly raised within the first 2 years of diagnosis, and superoxide dismutase, catalase, reduced glutathione and vitamins C and E were significantly lowered. 3. These changes were correlated with the duration of the disease and were of a higher magnitude with the development of complications. 4. The results suggest that the antioxidant deficiency and excessive peroxide-mediated damage may appear early on in non-insulin-dependent diabetes mellitus, before the development of secondary complications.

This cross-sectional population-based study shows that, among urban south Indian Type 2 diabetic subjects, the prevalence of DN is 26.1% and that DN is significantly associated with age, glycated haemoglobin and duration of diabetes.

DNBOBJECTIVE -The aim of this study was to assess the association of intima-media thickness (IMT) and arterial stiffness with diabetic retinopathy in an Asian-Indian population that has very high prevalence rates of diabetes and coronary artery disease.RESEARCH DESIGN AND METHODS -The study was conducted on 600 type 2 diabetic subjects randomly selected from the Chennai Urban Rural Epidemiology Study (CURES), which is an ongoing population-based study of a representative population of Chennai. When present, retinopathy was graded according to a modified Early Treatment Diabetic Retinopathy Study grading system. IMT was determined using high-resolution B-mode ultrasonography. Arterial stiffness was measured by assessing the augmentation index (AI) using the Sphygmocor apparatus.RESULTS -Retinopathy was diagnosed in 116 of 590 (19.6%) subjects in whom retinal photography was possible. Mean values of IMT (0.93 Ϯ 0.36 vs. 0.85 Ϯ 0.21 mm, P ϭ 0.001) and AI (27.9 Ϯ 8.9 vs. 25.8 Ϯ 9.6%, P ϭ 0.031) were significantly higher among diabetic subjects with retinopathy compared with those without. Both IMT (P ϭ 0.024) and AI (P ϭ 0.050) showed a significant association to diabetic retinopathy, even after adjusting for age, duration of diabetes, HbA 1c , serum cholesterol, serum triglycerides, and microalbuminuria.CONCLUSIONS -Diabetic retinopathy is associated with IMT and AI, suggesting that common pathogenic mechanisms might predispose to diabetic micro-and macroangiopathy. Diabetes Care 27:1962-1967, 2004D iabetic vascular complications are classified into microangiopathy and microangiopathy, and it was earlier assumed that these were entirely different disease processes. However, the link between nephropathy, particularly microalbuminuria and cardiovascular disease, is becoming increasingly apparent (1). Recent studies (2,3) have shown that diabetic retinopathy is associated with atherosclerotic end points, but most of these studies have looked at the end stages of the atherosclerotic process. Since the clock for atherosclerosis starts ticking even before the onset of diabetes (4), it would be of interest to study whether structural changes, such as carotid intima-media thickness (IMT) (5), and functional changes, such as arterial stiffness (6), are associated with diabetic retinopathy. While a few studies (7-9) have looked at the association between IMT and diabetic retinopathy, to our knowledge there are no studies that have looked at the association of retinopathy with arterial stiffness. In this study we report on the association of IMT and arterial stiffness with retinopathy in a populationbased study of Asian Indians, a high-risk group for diabetes (10) and coronary artery disease (CAD) (11). RESEARCH DESIGN AND METHODS -The study subjects were recruited from the Chennai Urban Rural Epidemiology Study (CURES).CURES is an ongoing epidemiological study conducted on a representative population (aged Ն20 years) of Chennai (formerly Madras), the fourth largest city in India, with a population of ϳ4.2 million. The method...

There is a significant association of serum triglycerides with DR and LDL-cholesterol with DME.

In South Indian Type 2 diabetic subjects, duration of diabetes, HbA1c, male gender, macroalbuminuria and insulin therapy were independent risk factors for severity of DR. Postprandial hyperglycaemia indicated a higher risk for DR compared with elevated fasting plasma glucose levels.

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