medwireNews: African–Caribbean ethnicity may be a predisposing factor for sight-threatening diabetic retinopathy (STDR) in people with type 1 diabetes, research suggests.
During 14 years of follow-up approximately 40% of people with African–Caribbean ethnicity remained free of STDR, compared with 60% of those with other ethnic origins, reported Anastasios Mangelis (King’s College London, UK) at the virtual 57th EASD Annual Meeting.
STDR was defined as any moderate-to-severe retinopathy (non-proliferative, pre-proliferative, or proliferative) and/or maculopathy, the presenter noted.
There were 326 African–Caribbean people in the study, identified in primary care medical records, and 1550 people of other ethnicities, predominantly Caucasian.
In all, 19.1% of the cohort developed STDR, with African–Caribbean people accounting for 24.0% of these people, despite accounting for just 17.4% of the overall cohort. And African–Caribbean ethnicity remained an independent predictor of STDR in multivariate analysis, increasing the risk by 43%.
Increasing duration of diabetes was also associated with STDR risk, with, for example, a 52% increased risk associated with a duration of at least 20 years compared with 0–9 years. There was also a slight but significant increase associated with having higher glycated hemoglobin.
African–Caribbean people were significantly younger than other study participants, at a median of 27 versus 30 years, and had a shorter duration of diabetes at baseline, at 4 versus 6 years, but higher glycated hemoglobin, at 84.7 versus 68.3 mmol/mol (9.9 vs 8.4%).
Higher blood pressure was associated with retinopathy risk in the univariate analysis, but not after adjustment for confounders. There was no link with other assessed variables, including BMI or socioeconomic status.
Mangelis noted that previous research in this cohort indicated that African–Caribbean people with diabetes also have an increased nephropathy risk relative to other ethnicities.
He said that further study is needed to determine why, but stressed: “What’s important here is that we need to ensure regular screening, earliest identification as possible, and also [multifactorial] intervention to reduce retinopathy progression – so blood pressure control, glucose control, and so on and so forth.”
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