South Asians with type 2 diabetes are significantly more at risk of losing their eyesight and losing it at an earlier age, compared to White Europeans with the same condition.

A UK study carried out by the University of Warwick shows diabetic retinopathy (damage to the retina) is more prevalent in South Asians and occurs earlier than in White European people with diabetes.

The study, published in the latest issue of Diabetes Care, looked at 1.035 patients with type 2 diabetes, 421 were of South Asian origin and 614 were White Europeans. The results showed 45% of South Asians had retinopathy, compared to 37% of White Europeans, and 16% of the South Asian group had sight threatening retinopathy, compared to 12% White Europeans.

South Asian diabetes patients were also significantly younger than the White European group. The average age of the South Asian group at diagnosis of diabetes was 53 years, compared to 57 years for White Europeans. The study also suggested South Asians developed diabetic retinopathy about seven years earlier than White Europeans.

This study is part of the UK Asian Diabetes Study, a randomised controlled trial designed to evaluate the benefits of an enhanced diabetes care package for people of South Asian ethnicity with type 2 diabetes in Coventry and Birmingham.

For this project, researchers collected clinical data from 10 GP practices in the Foleshill area of Coventry. Details on risk factors including blood pressure, duration of diabetes, age at onset of diabetes and cholesterol were recorded.

One of the study’s authors Professor Sudhesh Kumar, Professor of Medicine, Diabetes & Endocrinology at Warwick Medical School, said the results emphasised the need for effective screening and earlier diagnosis of diabetes among the South Asian population.

He said: “The South Asian participants in this study had significantly higher systolic and diastolic blood pressures and cholesterol levels. Systematic screening for retinopathy, combined with intensive management of diabetes, including reduction of blood glucose and blood pressure, could help to reduce the incidence of visual impairment and blindness in ethnic minority groups across the world, addressing an important health inequality.”

In adults, the systolic pressure should be less than 120 mmHg and the diastolic pressure should be less than 80 mmHg. In this study, the South Asian participants recorded 144 mmHg systolic pressure and 84 mmHg diastolic pressure.

Professor Kumar added: “Health care professionals in developed and developing countries need to be aware of the potential contribution of diabetic retinopathy to visual loss in South Asian communities.”

Fellow author Dr Paul O’Hare, from Warwick Medical School, said: “Screening for diabetic retinopathy is becoming more systematic across the UK and the developed world. However, coverage rates and uptake among ethnic minority groups in inner city areas may be much lower than those for white Europeans. We need to address this to try and rectify these important health inequalities.”

Diabetes Care, volume 32, number 3, March 2009

Warwick University
http://www.warwick.ac.uk

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