Elsevier

Ophthalmology

Volume 116, Issue 2, February 2009, Pages 311-318
Ophthalmology

Original article
Prevalence of Diabetic Retinopathy in India: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study Report 2

https://doi.org/10.1016/j.ophtha.2008.09.010Get rights and content

Objective

The aim of the study was to estimate the prevalence of diabetic retinopathy in an urban Indian population older than 40 years.

Design

A population-based cross-sectional study.

Participants

Five thousand nine hundred ninety-nine subjects residing in Chennai, India, were enumerated.

Methods

A multistage random sampling, based on socioeconomic criteria, was followed. Identified subjects with diabetes mellitus (based on the World Health Organization criteria) underwent detailed examination at the base hospital. The fundi of all patients were photographed using 45°, 4-field stereoscopic digital photography. The diagnosis of diabetic retinopathy was based on Klein's classification of the Early Treatment Diabetic Retinopathy Study scale.

Main Outcome Measures

These included age- and gender-adjusted prevalence of diabetes and diabetic retinopathy, and correlation of prevalence with history-based risk factors.

Results

The age- and gender-adjusted prevalence rate of diabetes in an urban Chennai population was 28.2% (95% confidence interval [CI], 27.0–29.3), and the prevalence of diabetic retinopathy in general population was 3.5% (95% CI, 3.49–3.54). The prevalence of diabetic retinopathy in the population with diabetes mellitus was 18.0% (95% CI, 16.0–20.1). History-based variables that were significantly associated with increased risk of diabetic retinopathy included gender (men at greater risk; odds ratio [OR], 1.41; 95% CI, 1.04–1.91); use of insulin (OR, 3.52; 95% CI, 2.05–6.02); longer duration of diabetes (>15 years; OR, 6.43; 95% CI, 3.18–12.90); and subjects with known diabetes mellitus (OR, 2.98; 95% CI, 1.72–5.17). Differences in the socioeconomic status did not influence the occurrence of diabetic retinopathy.

Conclusions

The prevalence of diabetic retinopathy was 18% in an urban population with diabetes mellitus in India. The duration of diabetes is the strongest predictor for diabetic retinopathy.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Patients and Methods

The study design and research methodology of SN-DREAMS 1 is described in detail elsewhere.7 The study area was the metropolis of Chennai, with a population of 4.3 million, distributed in 155 divisions of 10 zones. The estimated sample size was 5830 (the decision was to enumerate approximately 6000: approximately 600 from each of the 10 zones), assuming the prevalence of DR in the general population to be 1.3% (relative precision, 25%; dropout rate, 20%; design effect, 2).7 The sample was

Results

The data were compared between responders (n = 1563 who visited the base hospital) and nonresponders (n = 253 who did not visit the base hospital) with regard to mean age, gender, diabetes status, and mean fasting blood sugar. No statistically significant differences were observed (Table 1).

The age- and gender-adjusted prevalence of diabetes mellitus for the urban Chennai population was 28.2% (95% confidence interval [CI], 27.0–29.3). The prevalence of diabetes in lower, middle, and high

Discussion

This study (2003–2006) shows that the age- and gender-adjusted prevalence of diabetes mellitus in a population older than 40 years was 28.2%. Table 4 shows various studies on the prevalence of diabetes mellitus from India.12, 13, 14, 15, 16

There were 2 reports wherein the definition of diabetes mellitus was similar to that in the present study; the data showed that the prevalence of diabetes mellitus is rising gradually in India.12, 13 Other reports that used an oral glucose tolerance test in

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    Manuscript no. 2008-377.

    Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

    Supported by the RD Tata Trust, Mumbai, India.

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