Prevalence of Diabetic Retinopathy Continues to Rise
June 18, 2009
Preliminary data indicates that the prevalence of diabetic retinopathy has increased across ethnic/racial borders from 1988-1994 according to the latest 2005-2006 National Health and Nutrition Examination Survey. The researchers indicate that while this may be due to a change in screening techniques for diabetic retinopathy, it may also mean that glycemic control in the diabetic population is getting worse, that is, patients are not keeping good control of their serum glucose.
Increases were noted in non-hispanic whites, non-hispanic blacks and Mexican americans. While all 3 groups saw a rise, the non-hispanic blacks demonstrated the highest prevalence of diabetic retinopathy.
The prevalence of non-proliferative disease was about 20% with just 3% demonstrating proliferative eye disease. Interestingly, the highest risk factor to developing the disease is still the number of years a patient is diabetic. For every 5 years a patient is diabetic, the chances of demonstrating the disease increases by 60%.
Other associated risk factors include; male gender, difficulty in controlling sugar (e.g. insulin vs. oral vs. diet/exercise), higher systolic blood pressure and higher hemoglobin A1C.
What does this mean? To me, this underscores the importance of carefully explaining that the development of eye disease is highly likely to develop despite good sugar control. Patients should be told to expect the development of the eye disease as time progresses as the duration of the disease is a huge factor. Sugar control is important, but not the key to preventing disease.
For a more complete discussion of these issues, see the article on MedPage Today.
Randall V. Wong, M.D.
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