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Govindasamy Kumaramanickavel, Sunita Mohan, Arvind Kumar Singh, Radhika Srinivasan, Sundaram Natarajan, Catherine A McCarty; AJDRUMSS - Diabetic Retinopathy Prevalence Study in Mumbai Slums of India - Association of Demographic, Genetic and Medical Risk Factors.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1453.
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Diabetic retinopathy (DR) is the leading cause of blindness in the working-age group and the fastest growing visual impairment in India. We undertook the prevalence study in the Mumbai urban slums of India, which has a very high immigrant population, who come in search of jobs from rural India. Data for urban and rural India on DR is available, mostly in the south, however such data for western India and more so for the slums in India are sparsely available. This study is to determine the demographic, genetic and medical risk factors and their association with DR in this population.
Aditya Jyot Diabetic Retinopathy in Urban Mumbai Slums Study (AJDRUMSS) is a prospective cross-sectional study done in non-randomly selected seven wards of urban slums of Mumbai from January 2011-June 2014. The study population was aged ≥ 40 years, after diagnosed with type 2 diabetes mellitus (T2DM) based on field fasting blood sugar (FBS) estimation. Information related to history of DM and DR, family history, consanguieneous marriage practices, medications history and lifestyle practices were recorded, after which they underwent comprehensive ophthalmic examination.
A total of 6520 subjects were studied, gender based comparisons of risk factors with DR reveal statistically significant differences in occurrence of DR with mean duration of DM in both female and male subjects (p =0.001 and p<0.001 respectively) and mean difference in systolic BP among female subjects (p = 0.017). Presence of DR was positively associated with (i) male gender (OR 1.71; 95% CI, 1.11-2.65), (ii) use of oral hypoglycemic agents (OR 2.95; 95% CI, 1.14-7.60) and (iii) insulin medication (OR 5.53; 95% CI, 1.45-21.07). The risk factors not associated with DR were female gender, family history and consanguinity.
AJDRUMSS is a prevalence study of DR in one of the largest slums of the world - Mumbai, India. The risk factors associated in the AJDRUMSS study were male gender, medication for diabetes in both oral hypoglycaemic agents and insulin, systolic hypertension in females. Slums are the most medically neglected group and are one of the fastest growing populations in the world. We found out that those who took medications are more susceptible to develop retinopathy and therefore needed medical, particularly ophthalmic surveillance that was sparsely available to them.
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