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ORIGINAL ARTICLE
Year : 2020  |  Volume : 68  |  Issue : 13  |  Page : 21-26

Spectrum of eye disorders in diabetes (SPEED) in India. Report # 2. Diabetic retinopathy and risk factors for sight threatening diabetic retinopathy in people with type 2 diabetes in India


1 Department of Ophthalmology, Dr. Mohan's Diabetes Specialties Centre and Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
2 Department of Vitreo-Retina, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
3 Department of Vitreo-Retina, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
4 Department of Vitreo-Retina, L V Prasad Eye Institute, Hyderabad, Telangana, India
5 London School of Hygiene and Tropical Medicine, London, UK
6 Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India

Correspondence Address:
Dr. Ramachandran Rajalakshmi
Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, (ICMR Centre for Advanced Research on Diabetes) No 6, Conran Smith Road, Gopalapuram, Chennai - 600 086, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_21_19

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Purpose: To assess the proportion of people with type 2 diabetes mellitus (T2DM) with diabetic retinopathy (DR) and sight-threatening DR (STDR) and associated risk factors in select eye-care facilities across India. Methods: In this observational study, data of people with T2DM presenting for the first time at the retina clinic of eye-care facilities across India was recorded. Data collected in 2016 over 6 months included information on systemic, clinical, and ocular parameters. International Clinical Diabetic Retinopathy (ICDR) classification scale was used to grade DR. STDR was defined as presence of severe nonproliferative (NPDR), proliferative diabetic retinopathy (PDR), and/or diabetic macular edema (DME). Results: The analysis included 11,182 people with T2DM from 14 eye-care facilities (mean age 58.2 ± 10.6 years; mean duration of diabetes 9.1 ± 7.6 years; 59.2% male). The age-standardized proportion of DR was 32.3% (95%Confidence Interval, CI: 31.4-33.2) and STDR was 19.1% (95%CI: 18.4-19.8). DME was diagnosed in 9.1% (95%CI: 8.5-9.6) and 10.7% (95%CI: 10.1-11.3) people had PDR. Statistically significant factors associated with increased risk of DR (by multivariate logistic regression analysis) were: male gender (Odds ratio[OR] 1.57, 95%CI: 1.16-2.15); poor glycemic control–glycated hemoglobin (HbA1c >10%)(OR 2.39, 95% CI: 1.1-5.22); requirement of insulin (OR 2.55, 95%CI: 1.8-3.6);history of hypertension (OR 1.42, 95%CI: 1.06-1.88) and duration of diabetes >15 years (OR 5.25, 95%CI: 3.01-9.15). Conclusion: Diabetic retinopathy was prevalent in 1/3rd and sight-threatening DR in 1/5th of people with T2DM presenting at eye-care facilities in this pan-India facility-based study. The duration of diabetes was the strongest predictor for retinopathy.


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