Prevalence of Diabetes and Diabetic Retinopathy in a Population-Based Cohort of Adult Latinos. The Los Angeles Latino Eye Study (LALES)

Abstract

Abstract: : Purpose: To determine the prevalence of diabetes and diabetic retinopathy in a population-based sample of Latinos aged 40 and older. Methods: A population-based cohort of Latinos underwent a complete ophthalmic examination including standard 7-field stereoscopic fundus photographs and measurements of blood glucose and glycosylated hemoglobin (HbA1c). Diabetes was defined as Definite if there was a history of diabetes with current treatment and/or glucose measurements of > 200 mg% and/ or HbA1c of > 7.0 %. Diabetes status was defined as questionable if there was a history of diabetes with no current treatment and glucose levels of <200 mg% and a HbA1c of 6.5-6.9%. Diabetic retinopathy was evaluated by trained graders in a masked manner using the Airlie House Classification scheme and ETDRS severity scale Results: Of the 5238 participants who were examined, 1237 (23.6%) had diabetes. Eight hundred and eighty (71%) participants had a previous history of diabetes. Three hundred and fifty one (29%) were newly diagnosed. One thousand and seventy (86.5%) had definite diabetes and 167 (13.5%) had questionable diabetes. Of those with diabetes, 470 (37.9%) had diabetic retinopathy - 413 (87.9%) had non-proliferative diabetic retinopathy (BPDR) and 57 (12.1%) had proliferative diabetic retinopathy (PDR). NPDR was classified as mild in 123 (29.8%), moderate in 240 (58.11%) and severe in 50 (12.10%). Macular edema was found in 146 (13.7%) participants with 56 (4.5%) having clinically significant macular edema. Overall, any diabetic retinopathy was most prevalent in the 50-59 year age group. PDR was most prevalent in the 60-69 year age group. Conclusions: The prevalence of diabetes and diabetic retinopathy is high in this cohort of Latinos and comparable to other studies in Latinos. Furthermore, over a quarter of the participants with diabetes were previously undiagnosed. Given the high prevalence of diabetes and its associated microvascular complications in Latinos, screening and early treatment programs directed at Latinos would help decrease the morbidity and mortality associated with this chronic disease.

Keywords: diabetes • diabetic retinopathy