Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar 14:10:17.
doi: 10.1186/s13098-018-0319-4. eCollection 2018.

Regional differences in the prevalence of diabetic retinopathy: a multi center study in Brazil

Karla Rezende Guerra Drummond  1 , Fernando Korn Malerbi  2 , Paulo Henrique Morales  2 , Tessa Cerqueira Lemos Mattos  3 , André Araújo Pinheiro  4 , Felipe Mallmann  5 , Ricardo Vessoni Perez  6 , Franz Schubert Lopes Leal  7 , Laura Gomes Nunes de Melo  1 , Marília Brito Gomes  1 ; Brazilian Type 1 Diabetes Study Group
Collaborators, Affiliations

Regional differences in the prevalence of diabetic retinopathy: a multi center study in Brazil

Karla Rezende Guerra Drummond et al. Diabetol Metab Syndr. .

Abstract

Background: Diabetic retinopathy has a significant impact in every healthcare system. Despite that fact, there are few accurate estimates in the prevalence of DR in Brazil's different geographic regions, particularly proliferative DR and diabetic macular edema. This study aims to determine the prevalence of diabetic retinopathy in Brazil's five continental regions and its determinant factors.

Methods: This multi center, cross-sectional, observational study, conducted between August 2011 and December 2014, included patients with type 1 diabetes from the 5 Brazilian geographic regions (South, Southeast, North, Northeast and Midwest). During a clinical visit, a structured questionnaire was applied, blood sampling was collected and each patient underwent mydriatic binocular indirect ophthalmoscopy evaluation.

Results: Data was obtained from 1644 patients, aged 30.2 ± 12 years (56.1% female, 54.4% Caucasian), with a diabetes duration of 15.5 ± 9.3 years. The prevalence of diabetic retinopathy was 242 (36.1%) in the Southeast, 102 (42.9%) in the South, 183 (29.9%) in the North and Northeast and 54 (41.7%) in the Midwest. Multinomial regression showed no difference in the prevalence of non-proliferative diabetic retinopathy in each geographic region, although, prevalence of proliferative diabetic retinopathy (p = 0.022), and diabetic macular edema (p = 0.003) was higher in the Midwest. Stepwise analyses reviled duration of diabetes, level of HbA1c and hypertension as independent variables.

Conclusions: The prevalence of non proliferative diabetic retinopathy in patients with type 1 diabetes was no different between each geographic region of Brazil. The Midwest presented higher prevalence of proliferative diabetic retinopathy and diabetic macular edema. Duration of DM and glycemic control is of central importance to all. Hypertension is another fundamental factor to every region, at special in the South and Southeast. Glycemic control and patients in social and economic vulnerability deserves special attention in the North and Northeast of Brazil.

Keywords: Diabetic macular edema; Diabetic retinopathy; Risk factors.

PubMed Disclaimer

References

    1. Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet. 2010;376(9735):124–136. doi: 10.1016/S0140-6736(09)62124-3. - DOI - PubMed
    1. Bourne RR, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, et al. Causes of vision loss worldwide, 1990–2010: a systematic analysis. Lancet Glob Health. 2013;1(6):e339–e349. doi: 10.1016/S2214-109X(13)70113-X. - DOI - PubMed
    1. World Health Organization. Health topics: blindness. 2015. http://www.who.int/topics/blindness/en/. Accessed 3 Apr 2017.
    1. Center for Disease Control and Prevention. Improving the Nation’s Vision Health. A coordinated public health approach. 2012. http://www.cdc.gov/visionhealth/pdf/improving_nations_vision_health.pdf. Accessed 3 Dec 2016.
    1. Gomes MB, et al. Retirement due to disabilities in patients with type 1 diabetes a nationwide multi center survey in Brazil. BMC Public Health. 2015;15:486–495. doi: 10.1186/s12889-015-1812-4. - DOI - PMC - PubMed

LinkOut - more resources