Raymond, Neil T., Varadhan, Lakshminarayanan, Reynold, Dilini R., Bush, K., Sankaranarayanan, Sailesh, Bellary, Srikanth, Barnett, A. H. (Anthony H.), 1951-, Kumar, Sudhesh and O'Hare, J. Paul (2009) Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community : a cross-sectional study. Diabetes Care, Vol.32 (No.3). pp. 410-415. ISSN 0149-5992

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Abstract

OBJECTIVE - The purpose of this study was to compare prevalence and risk factors for diabetic retinopathy among U.K. residents of South Asian or white European ethnicity.

RESEARCH DESIGN AND METHODS - This was a community-based cross-sectional study involving 10 general practices; 1,035 patients with type 2 diabetes were studied: 421 of South Asian and 614 of white European ethnicity. Diabetic retinopathy, sight-threatening retinopathy, maculopathy, and previous laser photocoagulation therapy were assessed after grading of retinal photographs. Data were collected on risk factors including age, duration, and treatment of diabetes, blood pressures, serum total cholesterol, and A1C.

RESULTS - Patients of South Asian ethnicity had significantly higher systolic (144 vs. 137 mmHg, P < 0.0001) and diastolic (84 vs. 74 mmHg, P < 0.0001) blood pressure, A1C (7.9 vs. 7.5%, P < 0.0001), and total cholesterol (4.5 vs. 4.2 mmol/l, P < 0.0001). Diabetic retinopathy was detected in 414 (40%) patients (189 South Asian [45%] versus 225 white European [37%]; P = 0.0078). Sight-threatening retinopathy was detected in 142 (14%) patients (68 South Asian [16%] versus 74 white European [12%]; P = 0.0597). After adjustment for confounders, there were significantly elevated risks of any retinopathy and maculopathy for South Asian versus white European patients.

CONCLUSIONS - Patients of South Asian ethnicity had a significantly higher prevalence of diabetic retinopathy and maculopathy, with significantly elevated systolic and diastolic blood pressure, A1C, and total cholesterol; lower attained age; and younger age at diagnosis. Earlier onset of disease and higher levels of modifiable risk factors make early detection of diabetes, annual referral for retinal screening, and intensive risk factor control key elements in addressing this health inequality.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RE Ophthalmology
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Translational & Systems Medicine > Metabolic and Vascular Health Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Diabetics -- Great Britain, South Asians -- Health and hygiene -- Great Britain, Europeans -- Health and hygiene -- Great Britain, Diabetic retinopathy -- Great Britain, Diabetic retinopathy -- Risk factors -- Great Britain
Journal or Publication Title:	Diabetes Care
Publisher:	American Diabetes Association
ISSN:	0149-5992
Official Date:	March 2009
Volume:	Vol.32
Number:	No.3
Number of Pages:	6
Page Range:	pp. 410-415
Identification Number:	10.2337/dc08-1422
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Pfizer Inc., sanofi aventis (Firm), Servier Laboratories Ltd., Merck Sharp & Dohme/Schering-Plough, Roche, Merck Pharmaceuticals, Daiichi-Sankyo UK, Boehringer Ingelheim Pharmaceuticals (BIP), Eli Lilly and Company, Novo Nordisk, Bristol-Meyers Squibb (BMS), Solvay Pharmaceuticals, Assurance Medical Society UK (AMS UK)
URI:	http://wrap.warwick.ac.uk/id/eprint/28343

Data sourced from Thomson Reuters' Web of Knowledge

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