Ethnic disparities in the development of sight-threatening diabetic retinopathy in a uk multi-ethnic population with diabetes: An observational cohort study

Manjula D. Nugawela, Sarega Gurudas, Andrew Toby Prevost, Rohini Mathur, John Robson, Wasim Hanif, Azeem Majeed, Sobha Sivaprasad

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Abstract

There is little data on ethnic differences in incidence of DR and sight threatening DR (STDR) in the United Kingdom. We aimed to determine ethnic differences in the development of DR and STDR and to identify risk factors of DR and STDR in people with incident or prevalent type II diabetes (T2DM). We used electronic primary care medical records of people registered with 134 general practices in East London during the period from January 2007–January 2017. There were 58,216 people with T2DM eligible to be included in the study. Among people with newly diagnosed T2DM, Indian, Pakistani and African ethnic groups showed an increased risk of DR with Africans having highest risk of STDR compared to White ethnic groups (HR: 1.36 95% CI 1.02–1.83). Among those with prevalent T2DM, Indian, Pakistani, Bangladeshi and Caribbean ethnic groups showed increased risk of DR and STDR with Indian having the highest risk of any DR (HR: 1.24 95% CI 1.16–1.32) and STDR (HR: 1.38 95% CI 1.17–1.63) compared with Whites after adjusting for all covariates considered. It is important to optimise prevention, screening and treatment options in these ethnic minority groups to avoid health inequalities in diabetes eye care.

Original languageEnglish
Article number740
Number of pages17
JournalJournal of Personalized Medicine
Volume11
Issue number8
DOIs
Publication statusPublished - 28 Jul 2021
Externally publishedYes

Bibliographical note

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Funder

This study was part of the ORNATE India project which was funded by the GCRF UKRI (MR/P027881/1). The research is supported by the NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. AM is supported by the NIHR Applied Research Collaboration (ARC) NW London and is an NIHR Senior Investigator. The views expressed in this publication are those of the authors and not necessarily those of the NHS, NIHR or the Department of Health and Social Care. RM is supported by a Sir Henry Wellcome Postdoctoral fellowship from the Wellcome Trust (201375/Z/16/Z).

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Ethnicity
  • General practice
  • Retinopathy
  • Risk factors
  • Type 2 diabetes

ASJC Scopus subject areas

  • Medicine (miscellaneous)

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