Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community

a cross-sectional study

Neil T. Raymond, Lakshminarayanan Varadhan, Dilini R. Reynold, Kate Bush, Sailesh Sankaranarayanan, Srikanth Bellary, Anthony H. Barnett, Sudhesh Kumar, J. Paul O'Hare,

Research output: Contribution to journalArticle

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.
Original languageEnglish
Pages (from-to)410-415
Number of pages6
JournalDiabetes Care
Volume32
Issue number3
Early online date15 Dec 2008
DOIs
Publication statusPublished - Mar 2009

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Diabetic Retinopathy
European Union
Cross-Sectional Studies
Blood Pressure
Cholesterol
Light Coagulation
Laser Therapy
General Practice
Type 2 Diabetes Mellitus
Referral and Consultation
Health
Serum
Therapeutics

Keywords

  • adult
  • aged
  • Asian continental ancestry group
  • blood pressure
  • cholesterol
  • cross-sectional studies
  • type 2 diabetes mellitus
  • diabetic retinopathy
  • European continental ancestry group
  • female
  • Great Britain
  • humans
  • male
  • middle aged
  • prevalence

Cite this

Raymond, Neil T. ; Varadhan, Lakshminarayanan ; Reynold, Dilini R. ; Bush, Kate ; Sankaranarayanan, Sailesh ; Bellary, Srikanth ; Barnett, Anthony H. ; Kumar, Sudhesh ; O'Hare, J. Paul. / Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community : a cross-sectional study. In: Diabetes Care. 2009 ; Vol. 32, No. 3. pp. 410-415.
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title = "Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community: a cross-sectional study",
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.",
keywords = "adult, aged, Asian continental ancestry group, blood pressure, cholesterol, cross-sectional studies, type 2 diabetes mellitus, diabetic retinopathy, European continental ancestry group, female, Great Britain, humans, male, middle aged, prevalence",
author = "Raymond, {Neil T.} and Lakshminarayanan Varadhan and Reynold, {Dilini R.} and Kate Bush and Sailesh Sankaranarayanan and Srikanth Bellary and Barnett, {Anthony H.} and Sudhesh Kumar and O'Hare, {J. Paul}",
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Raymond, NT, Varadhan, L, Reynold, DR, Bush, K, Sankaranarayanan, S, Bellary, S, Barnett, AH, Kumar, S, O'Hare, JP 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. https://doi.org/10.2337/dc08-1422

Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community : a cross-sectional study. / Raymond, Neil T.; Varadhan, Lakshminarayanan; Reynold, Dilini R.; Bush, Kate; Sankaranarayanan, Sailesh; Bellary, Srikanth; Barnett, Anthony H.; Kumar, Sudhesh; O'Hare, J. Paul.

In: Diabetes Care, Vol. 32, No. 3, 03.2009, p. 410-415.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community

T2 - a cross-sectional study

AU - Raymond, Neil T.

AU - Varadhan, Lakshminarayanan

AU - Reynold, Dilini R.

AU - Bush, Kate

AU - Sankaranarayanan, Sailesh

AU - Bellary, Srikanth

AU - Barnett, Anthony H.

AU - Kumar, Sudhesh

AU - O'Hare, J. Paul

PY - 2009/3

Y1 - 2009/3

N2 - 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.

AB - 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.

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KW - aged

KW - Asian continental ancestry group

KW - blood pressure

KW - cholesterol

KW - cross-sectional studies

KW - type 2 diabetes mellitus

KW - diabetic retinopathy

KW - European continental ancestry group

KW - female

KW - Great Britain

KW - humans

KW - male

KW - middle aged

KW - prevalence

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M3 - Article

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EP - 415

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

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