Abstract
AimsTo compare the prevalence of diabetic retinopathy (DR) in people of various ethnic groups with diabetes in the United Kingdom (UK).MethodsThe Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK) Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London) or August 2009 (West Yorkshire) were included in the study. Data included age, sex, ethnic group, type of diabetes, presenting visual acuity and the results of grading of diabetic retinopathy. Prevalence estimates for the ethnic groups were age-standardised to the white European population for comparison purposes.ResultsOut of 57,144 people on the two diabetic registers, data were available on 50,285 individuals (88.0%), of these 3,323 had type 1 and 46,962 had type 2 diabetes. In type 2 diabetes, the prevalence of any DR was 38.0% (95% confidence interval(CI) 37.4% to 38.5%) in white Europeans compared to 52.4% (51.2% to 53.6%) in African/Afro-Caribbeans and 42.3% (40.3% to 44.2%) in South Asians. Similarly, sight threatening DR was also significantly more prevalent in Afro-Caribbeans (11.5%, 95% CI 10.7% to 12.3%) and South Asians (10.3%, 9.0% to 11.5%) compared to white Europeans (5.5%, 5.3% to 5.8%). Differences observed in Type 1 diabetes did not achieve conventional levels of statistical significance, but there were lower numbers for these analyses.ConclusionsMinority ethnic communities with type 2 diabetes in the UK are more prone to diabetic retinopathy, including sight-threatening retinopathy and maculopathy compared to white Europeans.
Highlights
Diabetic retinopathy (DR) is the most common microvascular complication of diabetes
New vessels grow on the retina; this is known as proliferative retinopathy and accounts for the majority of severe visual loss
In type 2 diabetes, the prevalence of any DR was significantly higher in the African/Afro-Caribbean group (52.4%, 95% confidence intervals (CI)51.2% to 53.6%) and South Asians (42.3%, 95% CI 40.3% to 44.2%) compared to white Europeans (38%, 95% CI 37.4% to 38.5%)
Summary
Diabetic retinopathy (DR) is the most common microvascular complication of diabetes. Visual loss from diabetic retinopathy results primarily from two complications. New vessels grow on the retina; this is known as proliferative retinopathy and accounts for the majority of severe visual loss. Retinal blood vessels can become permeable and cause swelling of the centre of the retina, called diabetic macular oedema. Significant macular oedema is a leading cause of moderate visual loss in diabetes. Proliferative retinopathy, severe non-proliferative retinopathy and clinically significant macular oedema can be considered as sight threatening retinopathy. The established risk factors of DR include prolonged exposure to hyperglycaemia and hypertension. DR can progress despite optimal control of these risk factors [1]
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