Risk factors for diabetic retinopathy in a South Indian Type 2 diabetic population-the Chennai Urban Rural Epidemiology Study (CURES) Eye Study 4

• Published in: Diabetic medicine Vol. 25; no. 5; pp. 536 - 542
• Main Authors: Pradeepa, R., Anitha, B., Mohan, V., Ganesan, A., Rema, M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2008; Blackwell
• Subjects: Biological and medical sciences; Chennai Urban Rural Epidemiology Study Eye Study; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; diabetic retinopathy; Diabetic Retinopathy - epidemiology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epidemiologic Methods; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Fundamental and applied biological sciences. Psychology; Glycated Hemoglobin A - metabolism; Humans; India - epidemiology; Male; Medical sciences; Middle Aged; postprandial hyperglycaemia; Risk Factors; Rural Health; Sex Factors; South Indians; Urban Health; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Asia; India; Endocrinopathy; Type 2 diabetes; Retinopathy; Chennai Urban Rural Epidemiology Study Eye Study; Urban area; Epidemiology; Eye; Visual system; Hyperglycemia; Population; Nutritional status; Public health; Human; risk factors; Rural environment; Urban environment; Cure; Postprandial; South Indians; Nutrition disorder; South; postprandial hyperglycaemia; Metabolic diseases; diabetic retinopathy; Eye disease; Risk factor; Indian; Endocrinology
• ISSN: 0742-3071; 1464-5491; 1464-5491
• DOI: 10.1111/j.1464-5491.2008.02423.x

Aims  To determine risk factors for diabetic retinopathy (DR) in an urban South Indian Type 2 diabetic population. Methods  The Chennai Urban Rural Epidemiology Study is a large cross‐sectional study conducted in Chennai, South India. A total of 1736 Type 2 diabetic subjects were recruited for this study, which included 1382 known diabetic subjects (90.4% response rate) and 354 randomly selected, newly detected diabetic subjects diagnosed by oral glucose tolerance test. All subjects underwent four‐field stereo retinal colour photography, graded by the Early Treatment Diabetic Retinopathy Study protocol. Results  Of the 1736 Type 2 diabetic subjects photographed, photographs could be graded in 1715 subjects. Stepwise ordinal logistic regression analysis revealed that male gender (P = 0.041), duration of diabetes (P < 0.0001), glycated haemoglobin (HbA1c; P < 0.0001), macroalbuminuria (P = 0.0002) and insulin therapy (P = 0.0001) were significantly associated with severity of DR. The risk for developing DR was 7.7 times (95% confidence interval 4.71–12.48, P < 0.0001) for elevated postprandial plasma glucose levels compared with 4.2 times (95% confidence interval 2.78–6.34, P < 0.0001) for elevated fasting plasma glucose when the fourth quartile values were compared with the first quartile glucose values. Conclusions  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.