Prevalence and Risk Factors for Diabetic Retinopathy in the Multiethnic Population of Mauritius

Abstract

This study examines the prevalence of, and risk factors for, diabetic retinopathy in Asian Indian, Chinese, and Creole Mauritians in whom there is an increasing prevalence of non-insulin-dependent diabetes mellitus (NIDDM). As part of a population-based survey on the Indian Ocean island of Mauritius in 1992, glucose tolerance was classified using a 75-g oral glucose tolerance test on 6,553 persons. Subjects with newly diagnosed (n = 358) or known diabetes (n = 388), and a random sample of one in four subjects with impaired glucose tolerance (n = 165), had stereoscopic 45 degrees retinal photographs taken of three fields in the right eye after mydriasis. Photographs were graded according to a modified version of the Airlie House criteria. The prevalence of nonproliferative and proliferative retinopathy was: 14.5% and 0.3%, respectively, in newly diagnosed diabetic subjects; 42.0% and 2.3%, respectively, in known diabetic subjects; and 9.1% and 0%, respectively, in persons with impaired glucose tolerance. Muslim Indians had the lowest prevalence of retinopathy (10.8% and 34.0% for new and known diabetes, respectively), but after adjusting for other factors, this was significantly different only to Creoles (18.8% and 53.8%, respectively). Univariate analysis revealed significant differences between diabetic subjects with and without retinopathy in mean age, body mass index, fasting and 2-hour plasma glucose levels, systolic and diastolic blood pressure, fasting triglycerides, serum creatinine, and urinary albumin levels. For known diabetes, mean duration of diabetes and the proportion using insulin were also greater in those with retinopathy. Multivariate analysis using logistic regression confirmed that increasing duration of diabetes, fasting plasma glucose, systolic blood pressure, and urinary albumin concentration, and decreasing body mass index, were independently associated with retinopathy. The high prevalence of diabetic retinopathy observed in all major ethnic groups in Mauritius portends a serious public health problem, given the relative recency of the NIDDM epidemic in that country and the limited resources for laser photocoagulation. Strategies to minimize this problem among those already known to have diabetes should include strict control of plasma glucose and blood pressure.

Prevalence and risk factors of diabetic retinopathy in Chongqing pre-diabetes patients

“…In addition, small sample sizes and different grading criteria of DR in these three studies might be taken into consideration. Earlier studies have shown that age, 13,14 gender, 14,15 BMI, 16,17 WHR, 16 TC, 13 HDL-C, 18 LDL-C, 19 BUN, blood creatinine, 20 and UAER 21,22 have certain associations with DR in diabetics. However, in our study, it appears that those related above are not risk factors for DR in prediabetics.…”

The Prevalence of and Factors Associated With Diabetic Retinopathy in the Australian Population

“…Diabetes duration has been shown to be an independent risk factor for retinopathy in many studies (11,21). Duration of diabetes reflects total glycemic control and risk factor exposure over time (7). Although C-peptide was lower in those with retinopathy than those without, its significance disappeared once duration of diabetes was added to the model.…”

“…Although C-peptide was lower in those with retinopathy than those without, its significance disappeared once duration of diabetes was added to the model. Hypertension has frequently been shown to be a risk factor in the development of retinopathy (7,10,31). In the present study, elevated SBP had an increasing impact with longer duration of diabetes and higher HbA 1c values (Fig.…”

“…Internationally there have been many studies assessing the prevalence of retinopathy, though few have looked at both those with previously and newly diagnosed diabetes (6 -8), and only one from a developed country has used a nationally representative population (9). Several factors have consistently been identified by both cross-sectional and prospective studies as risk factors in the development of diabetic retinopathy: duration of diabetes, systolic blood pressure (SBP), glycemic control, and urinary albumin (7,10). Other factors, including BMI, smoking, serum lipids, and Cpeptide, have shown varying results (7, 10 -13).…”

Prevalence of Diabetic Retinopathy and Cataract in Adult Patients With Type 1 And Type 2 Diabetes in Russia

“…when the damaging effect on blood vessels and nerves has proceeded unnoticed for a long time. 50-70% of type 2 diabetes cases show DR symptoms after 10 years, and 90% of these patients after 30 years [4,5].Another complication leading to loss of sight is cataract. It is characterized by an opacification of the translucent media of the lens that progresses rapidly in diabetic patients.…”