Prevalence and determinants of diabetic retinopathy and cataracts in West African type 2 diabetes patients
Objective: To quantify the prevalence of, and risk factors for, diabetic retinopathy and cata- racts in patients with type 2 diabetes, and their spouse controls, enrolled from 5 centers in 2 West African countries (Ghana and Nigeria). Method: The analysis cohort was made up of 840 subjects with type 2 diabetes, and their 191 unaffected spouse controls, who were en- rolled and examined in Lagos, Enugu, and Iba- dan, in Nigeria, and in Accra and Kumasi, in Ghana. A diagnosis of diabetic retinopathy was made only where a participant had a mini- mum of one microaneurysm in any field, as well as exhibiting hemorrhages (dot, blot, or flame shaped), and maculopathy (with or with- out clinically significant edema). Results: Average duration of diabetes was 7.0 years, and mean age at diagnosis was 46.5 years. Prevalence of diabetic retinopathy was 17.9%. Cataracts were present in 44.9% of the patients with type 2 diabetes, and in 18.3% of spouse controls. The risk of developing reti- nopathy increased more than 3-fold for pa- tients at the highest fasting plasma glucose (FPG) level (OR3.4; 95% CI, 1.8–6.3), com- pared to patients at the lowest FPG level. The odds ratios for persons with diabetes for 10 years or more, compared to persons with di- abetes for less than 5 years, was 7.3 (95% CI, 4.3–12.3) for retinopathy, and 2.6 (95% CI, 1.5–4.5) for cataracts. Conclusions: Cataracts were a more impor- tant cause of vision impairment than was dia- betic retinopathy in this cohort. The preva- lence of cataracts in patients with diabetes was more than twice that of their spouse controls, indicating that type 2 diabetes is an important risk factor for cataract formation. Individuals who developed type 2 diabetes at an earlier age were more likely to develop both diabetic retinopathy and cataracts. A strong positive as- sociation was observed between FPG level, duration of diabetes, and risk of retinopathy and cataracts. The low prevalence of retinop- athy and cataracts observed within the first 5 years of diagnosis of diabetes in this cohort, suggests that intensive blood glucose control may reduce the risk of the development and progression of retinopathy and cataracts. In this regard, early eye examination, preferably at first presentation of elevated blood glucose, is highly recommended
Type 2 diabetes , Retinopathy , Cataracts , West Africa , Research Subject Categories::MEDICINE
Rotimi C, Daniel H, Zhou J, Obisesan A, Chen G, Chen Y, Amoah A, Opoku V, Acheampong J, Agyenim-Boateng K, Eghan BA Jr, Oli J, Okafor G, Ofoegbu E, Osotimehin B, Abbiyesuku F, Johnson T, Fasanmade O, Doumatey A, Aje T, Collins F, Dunston G. Prevalence and determinants of diabetic retinopathy and cataracts in West African type 2 diabetes patients. Ethn Dis. 2003 Summer;13(2 Suppl 2):S110-7.