Abstract
Abstract: :
Purpose: To evaluate the prevalence of diabetic retinopathy (DR) in Type II diabetic patients of Indian/Pakistani, African–American and Hispanic origins. Methods: A retrospective study was performed of all patients presenting to the diabetic screening clinic at the John H. Stroger, Jr. Hospital of Cook County Department of Ophthalmology from June, 2001 to April, 2002; and August, 2003 to November, 2003. There was no restriction of access to medical care due to race, age, sex, or ability to pay for medical services. Results: A total of 651 patients were included in this ongoing study. The study population consisted of Type II diabetics of whom 318 were African–Americans (AA), 263 were Hispanics (Hisp), and 70 were Indian/Pakistani (I/P). In the study population, the mean age was 55.9 years (31–88 yrs), duration of diabetes 7.9 years (1–34 yrs), and 387 were female (59.4%). Among the 3 ethnic groups, there were no statistically significant differences with respect to age, insulin use, duration of diabetes, or HbA1c. There was a statistically significant difference with respect to gender, hypertension (HTN) and retinopathy. Hispanics had a 46.8% rate of DR versus 31.8% for AA and 31.4% for I/P patients. The relative risk for retinopathy was 1.0 (95% CI) for Hisp, 0.44 (0.30 to 0.64 CI) (p<0.05) for AA and 0.58 for I/P (0.32 to 1.1 CI) when controlled for HbA1c, age, gender, HTN, duration of diabetes, and insulin use. Conclusions: The prevalence of DR for Hispanics and African–Americans in our study was comparable to that of prior studies. I/P patients, a previously unstudied group, were found to have higher rates of DR compared to studies of this group in indigenous populations in India. The majority of published reports from the Indian Subcontinent represent a Southern Indian population, but our study population consisted primarily of North Indians/Pakistanis. The differences noted may be explained by genetic differences between these populations or the impact of North American diet and lifestyle. Further studies are necessary to characterize the differences in rates of DR between gender and diverse ethnic groups. This may help to determine the most cost–effective methods for screening and intervention in diabetic eye disease.
Keywords: diabetic retinopathy • clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: health care delivery/economics/manpower