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Prevalence and risk factors for diabetic retinopathy in prediabetes in Asian Indians

Ramachandran Rajalakshmi1, Ganesan UmaSankari1, Sobha Sivaprasad2

  • 1Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India.

Journal of Diabetes and Its Complications
|January 30, 2022
PubMed

Insights

Diabetic retinopathy (DR) affects 6% of Asian Indians with prediabetes. Higher HbA1c levels in prediabetes significantly increase DR risk, highlighting the need for early glycemic control.

Area of Science:

  • Ophthalmology
  • Endocrinology
  • Public Health

Background:

  • Prediabetes is a growing concern globally, particularly in Asian Indian populations.
  • Diabetic retinopathy (DR) is a major microvascular complication of diabetes.
  • The prevalence and risk factors of DR in prediabetes are not well-established in this demographic.

Purpose of the Study:

  • To determine the prevalence of diabetic retinopathy (DR) in Asian Indians diagnosed with prediabetes.
  • To identify systemic risk factors associated with DR in this prediabetic population.

Main Methods:

  • A cross-sectional study involving 192 individuals with prediabetes (defined by OGTT/HbA1c 5.7%-6.4%) was conducted.
  • Clinical, biochemical assessments, and nonmydriatic ultra-wide field fundus photography were performed.
  • Retinal images were graded by certified ophthalmologists, and risk factors were analyzed.

Main Results:

  • Diabetic retinopathy (DR) was identified in 6.3% of individuals with prediabetes (mild NPDR in 4.7%, moderate NPDR in 1.6%).
  • No severe or sight-threatening DR was observed.
  • Higher HbA1c levels (≥6%) were significantly associated with a 2-fold increased relative risk of DR (RR 1.95, p=0.028) after adjusting for covariates.

Conclusions:

  • Approximately 6% of Asian Indians with prediabetes exhibit diabetic retinopathy.
  • Elevated HbA1c levels in the prediabetic stage are a significant risk factor for DR.
  • Emphasizing robust glycemic control before diabetes diagnosis is crucial to prevent DR.
Abstract

Keywords:
Diabetic retinopathyHbA1cPrediabetesUltrawide field retinal photography

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