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O. S. Huang, W. T. Tay, M. Sandar, E. L. Lamoureux, J. J. Wang, T. Y. Wong; Glycemic and Blood Pressure Control in Community-Living Individuals with Diabetes and Diabetic Retinopathy: The Singapore Malay Eye Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4430.
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To assess glycemic and blood pressure (BP) control in an adult Malay population with diabetes and diabetic retinopathy (DR), and identify characteristics associated with suboptimal control.
The Singapore Malay Eye Study was a population-based survey of 3,280 (78.7% response rate) Malays aged 40-80 years. Diabetes was defined as non-fasting glucose ≥11.1mmol/L, use of diabetic medication or physician diagnosis. DR was graded from retinal photographs using the modified Airlie House classification. HbA1c and BP levels were measured using standardized procedures, with optimal control defined as HbA1c <7% and BP ≤130/80mmHg.
In participants with diabetes (n=768), only 26.9% and 13.3% had optimal glycemic and BP control, respectively. In those with DR (n=272), the rates of optimal glycemic and BP control was even lower (17.4% and 10.3%, respectively). After adjusting for age, gender, socioeconomic status and other factors, compared to participants with optimal glycemic control, those with suboptimal control were younger (p=0.005); and more likely unaware of their diabetes status (p<0.001); on diabetic medication (p<0.001); have higher total serum cholesterol levels (p=0.009) and any DR (p<0.001). Similarly, in multivariate models, compared to participants with optimal BP control, those with suboptimal control were older (p=0.006); and more likely to have hypertension (p=0.04); higher total serum cholesterol levels (p=0.002); higher BMI (p=0.04) and any DR (p=0.02).
In this Asian population with diabetes and DR, a high proportion had poor glycemic and BP control. Strategies to further improve diabetes management and implement evidence-based guidelines are needed in order to reduce the burden of DR in this population.
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