Purchase this article with an account.
Liying Low, Simon Ogston, Peter Wilson, Carrie MacEwen; Is socioeconomic deprivation associated with prevalence of diabetic retinopathy in a free access national screening programme?. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5348.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To explore the association between socioeconomic deprivation and prevalence of diabetic retinopathy (DR) in type 1 and 2 Diabetes Mellitus (DM) patients in East of Scotland where free annual DR screening programme is provided to all patients with DM above the age of 12 years.
We collected data on diabetic retinopathy screening (digital retinal photography) from Scottish regional diabetes electronic record between January 2011 & December 2012. Using the residential postcode, we obtained the overall Scottish Index of Multiple Deprivation 2012 (SIMD) score for each patient. We used multiple logistic regression to analyse the relationship between overall SIMD score and prevalence of DR, adjusting for other variables: age, gender, HbA1c, cholesterol levels & duration of diabetes.
In patients with type 1 DM (n=1861), 88.2% attended their annual DR screening. Increased prevalence of DR in type 1 DM was independently associated with higher overall SIMD score(OR 1.01, 95% CI 1.00-1.02, p=0.008), male gender (OR 1.32, p=0.015), higher HbA1c value(OR 1.35, p<0.001), higher cholesterol levels (OR 1.174, p=0.03), younger age(OR 1.17, p=0.03), and longer duration of disease (OR 3.17, p<0.001). In contrast, 93.5% of type 2 DM patients (n=18197) attended their annual DR screening. The overall SIMD score was not independently associated with the prevalence of DR(OR 0.998, 95% CI 0.995-1.000, p=0.074). Prevalence of DR was strongly associated with longer duration of diabetes(OR 1.99, p<0.001), higher HbA1c value(OR 1.22, p<0.001), higher cholesterol levels(OR 1.07, p=0.001) and male gender(OR 1.19, p<0.001).
Socioeconomic deprivation is independently associated with increased prevalence of diabetic retinopathy in type 1 DM patients, but not for type 2 DM patients. This finding highlights the need for targeted interventions to address inequalities in eye healthcare.
This PDF is available to Subscribers Only