Purchase this article with an account.
Akshar Abbott, David Valent, Maggie Wei, Madia Ricks, Lilian Mabundo, Stephanie T Chung, Anne Sumner, Emily Y Chew; Glucose Tolerance Status as a marker of diabetic retinopathy in Africans: The Africans in America cohort. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6331.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The increasing prevalence of diabetes in Africa highlights the importance of early detection of diabetic retinopathy, prior to the onset of visual impairment. This study tested the hypothesis that elevated two hour glucose tolerance is associated with diabetic retinopathy in African immigrants who do not previously carry the diagnosis of impaired glucose tolerance or diabetes.
The enrollees were 81 African immigrants (61% male, age 43±9y,(mean±SD), range 25-61y, BMI 27.8±4.5 kg/m2, range 20.5-41.2) who self-identified as healthy and were participating in the Africans in American cohort. OGTT to determine glucose tolerance status and fundus photographs to detect diabetic retinopathy as well as other retinal pathology were performed in all enrollees.
Based on glucose thresholds established for the OGTT by the American Diabetes Association, 11 immigrants were classified as having diabetes, 29 as having pre-diabetes, and 41 had normal glucose tolerance. Based on 2h glucose levels obtained during the OGTT there were no significant differences in age or gender in the groups who had normal (<140 mg/dL), impaired (140-199 mg/dL), or diabetes (≥200 mg/dL). Six immigrants were identified as having diabetic retinopathy, 4 had diabetes by glucose tolerance testing, and 2 had pre-diabetes. Median A1c was not significantly different (p=0.277) between patients with diabetic retinopathy (5.85%) and without (5.50%), but median two-hour glucose tolerance test values were significantly higher (p = 0.0006) in participants with diabetic retinopathy (236.0 mg/dL) than those without (123.0 mg/dL). Other ocular abnormalities identified but unrelated to glucose tolerance status were: enlarged cup-to-disc ratio (49.3%), drusenoid changes (77%), areas of white without pressure (17.2%) and peripapillary atrophy (3.7%).
Our results indicate that glucose tolerance testing shows promise as a screening test to identify African patients without a known diagnosis of diabetes who may benefit from diabetic retinopathy screening.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only