The Impact of African Caribbean Heritage on the Development of Sight-Threatening Diabetic Retinopathy in a Multiethnic Cohort of People With Type 2 Diabetes
Authors' conclusion
In a multiethnic cohort of type 2 diabetes, we observed an increased risk of STDR in people of African Caribbean ethnicity, which was independent of traditional risk factors.
Study context
- Population
- People with T2D and no retinopathy at baseline attending a surveillance digital diabetes eye screening service in South London, 2004–2018; 49% female, 38% White Caucasian, 43.4% African Caribbean, 18.6% other racial/ethnic groups
- Participants
- 8,529 people
- Outcome
- STDR, with death as a competing event
Methodological detailsmultiethnic cohort, competing risk analysis, multivariable analysis
- Multiethnic cohort
- Competing risk analysis
- Multivariable analysis
Main finding
As reported in the abstract
Progression to STDR and independent factors associated with STDR · median follow-up 8.9 years
- Progressed to sight-threatening diabetic retinopathy (STDR)
- 489 (5.7%)
- African Caribbean ethnicity, HR
- 1.35 (1.13-1.62) (95% CI)
- Duration of diabetes, HR
- 1.05 (1.05-1.06) (95% CI)
- HbA1c, HR
- 1.02 (1.02-1.02) (95% CI)
- Total cholesterol, HR
- 1.13 (1.05-1.21) (95% CI)
Observational data: associations, not effects.
Further findings
Baseline characteristics of those progressing to STDR
- Higher baseline median (IQR) HbA1c in those progressing to STDR, mmol/mol
- 75.9 [58.4, 93.4] vs. 61.7 [49.9, 79.2]
- Longer duration of diabetes in those progressing to STDR, years
- 11 [7, 15] vs. 4 [2, 9]
- More likely to be of African Caribbean heritage
- P < 0.001 for all
Original publication
The Impact of African Caribbean Heritage on the Development of Sight-Threatening Diabetic Retinopathy in a Multiethnic Cohort of People With Type 2 Diabetes. Diabetes Care. Published 22 October 2025. doi:10.
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