People With Type 1 Diabetes of African Caribbean Ethnicity Are at Increased Risk of Developing Sight-Threatening Diabetic Retinopathy
Authors' conclusion
We observed that people with type 1 diabetes of African Caribbean ethnicity are at significantly greater risk of STDR. Further research is required to understand the mechanisms that explain this novel observation.
Study context
- Population
- People with T1D and no retinopathy at baseline attending surveillance eye screening (50% women, 72.1% Caucasian, 17.3% African Caribbean, 2.9% Asian, 7.6% other); median age 29 (21, 41) years
- Participants
- 1,876 people
- Exposure
- African Caribbean vs other ethnicities
- Outcome
- Referable sight-threatening diabetic retinopathy (STDR): moderate to severe nonproliferative or preproliferative DR, proliferative DR or maculopathy in either eye (UK National Diabetic Eye Screening criteria)
- Follow-up
- Median 6 years
Methodological detailsregional diabetes eye screening service, multivariable Cox regression
- Regional diabetes eye screening service
- Multivariable Cox regression
Main finding
As reported in the abstract
Independent risk factors for STDR (multivariable Cox regression)
Developed sight-threatening diabetic retinopathy (STDR)
359
19%
African Caribbean ethnicity, HR
1.39
95% CI 1.09–1.78P = 0.009
Baseline systolic blood pressure (SBP), HR
1.01
95% CI 1.00–1.01P = 0.033
Baseline HbA1c, HR
1.01
95% CI 1.00–1.01P = 0.0001
Observational data: associations, not effects.
Further findings
Baseline characteristics of those who developed STDR vs not
- African Caribbean origin, STDR vs no STDR
- 24% vs. 15.6%
- Those developing STDR had higher baseline HbA1c, raised SBP, longer DM duration and were more often African Caribbean (P < 0.05 for all)
Original publication
People With Type 1 Diabetes of African Caribbean Ethnicity Are at Increased Risk of Developing Sight-Threatening Diabetic Retinopathy. Diabetes Care. Published 26 April 2023. doi:10.
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