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. 2014 Jun 6;2(1):e000005.
doi: 10.1136/bmjdrc-2013-000005. eCollection 2014.

Prevalence and risk factors for diabetic retinopathy in rural India. Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study III (SN-DREAMS III), report no 2

Rajiv Raman  1 , Suganeswari Ganesan  1 , Swakshyar Saumya Pal  1 , Vaitheeswaran Kulothungan  2 , Tarun Sharma  1
Affiliations

Prevalence and risk factors for diabetic retinopathy in rural India. Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study III (SN-DREAMS III), report no 2

Rajiv Raman et al. BMJ Open Diabetes Res Care. .

Abstract

Objective: The study was aimed at estimating the prevalence of type 2 diabetes mellitus and diabetic retinopathy in a rural population of South India.

Design: A population-based cross-sectional study.

Participants: 13 079 participants were enumerated.

Methods: A multistage cluster sampling method was used. All eligible participants underwent comprehensive eye examination. The fundi of all patients were photographed using 45°, four-field stereoscopic digital photography, and an additional 30° seven-field stereo digital pairs were taken for participants with diabetic retinopathy. The diagnosis of diabetic retinopathy was based on Klein's classification.

Main outcome measures: Prevalence of diabetes mellitus and diabetic retinopathy and associated risk factors.

Results: The prevalence of diabetes in the rural Indian population was 10.4% (95% CI 10.39% to 10.42%); the prevalence of diabetic retinopathy, among patients with diabetes mellitus, was 10.3% (95% CI 8.53% to 11.97%). Statistically significant variables, on multivariate analysis, associated with increased risk of diabetic retinopathy were: gender (men at greater risk; OR 1.52; 95% CI 1.01 to 2.29), use of insulin (OR 3.59; 95% CI 1.41 to 9.14), longer duration of diabetes (15 years; OR 6.01; 95% CI 2.63 to 13.75), systolic hypertension (OR 2.14; 95% CI 1.20 to 3.82), and participants with poor glycemic control (OR 3.37; 95% CI 2.13 to 5.34).

Conclusions: Nearly 1 of 10 individuals in rural South India, above the age of 40 years, showed evidence of type 2 diabetes mellitus. Likewise, among participants with diabetes, the prevalence of diabetic retinopathy was around 10%; the strongest predictor being the duration of diabetes.

Keywords: Incidence; Retinopathy.

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Figures

Figure 1
Figure 1
Study areas.
Figure 2
Figure 2
(A) A customized mobile van for comprehensive eye examination in rural areas. (B) Inside the mobile van: recording visual acuity using the EDTRS chart.
Figure 3
Figure 3
Flow chart showing a step-by-step enrollment of the study population.
See this image and copyright information in PMC

References

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