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Defeat Diabetes: Diabetic Retinopathy a "Major Public Health Problem" in US

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Diabetic Retinopathy a "Major Public Health Problem" in US
posted 04/22/04
8% of those with diabetes will develop blinding retinopathy before age 40!

In the US, approximately 8% of diabetics develop potentially blinding retinopathy before the age of 40, epidemiologists report in the Archives of Ophthalmology. In a second report, researchers found that diabetic retinopathy threatens the vision of nearly 30% of adults with type 1 diabetes before 30 years of age.

The two research teams estimated the prevalence of diabetic retinopathy based on pooled data from population-based eye surveys, the 1999 National Health Interview Survey, and the 2000 US Census.

Dr. John H. Kempen, at Johns Hopkins University School of Medicine in Baltimore, and members of the Eye Diseases Prevalence Research Group, evaluated eight population-based studies in which the severity of diabetic retinopathy was graded by a color fundus photograph reading center. They defined vision-threatening disease as severe retinopathy, clinically significant macular edema or both.

The crude prevalence of retinopathy was 40.3%, and the crude prevalence for vision-threatening disease was 8.2%. In the general population, the corresponding prevalence was 3.4% and 0.75%, respectively.

Because the prevalence of diabetes varies in different ethnic groups, there are large differences in the prevalence of diabetic retinopathy, Dr. Kempen's group reports. Compared with white persons, Hispanics are approximately 1.5 times as likely and blacks are 1.3 times as likely to have diabetic retinopathy.

A second team of investigators, led by Dr. Monique S. Roy, at the University of Medicine and Dentistry-New Jersey Medical School in Newark, used data from the Wisconsin Epidemiologic Study of Diabetic Retinopathy and the New Jersey 725.

They found that 86.4% of type 1 diabetics between the ages of 18 to 30 have diabetic retinopathy, which threatens vision in 42.1%. In the general population, the corresponding prevalence was 0.37% and 0.18%, respectively.

Dr. Kempen's team points out that diabetic retinopathy often causes blindness during working-age years, and is thus associated with large economic costs. However, it is often preventable with intensive control of hyperglycemia and hypertension, along with detection and treatment of patients with high-risk diabetic retinopathy.

"Because diabetic retinopathy is a substantial public health problem, public and private policy efforts directed toward improving primary and secondary prevention programs are warranted," Dr. Roy's group writes.

"The key finding is that the burden of disease is large, and will become much larger as the population gets more elderly."

Source: Diabetes In Control.com: Arch Ophthalmol 2004;122:546-563.

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