Olvera-Barrios, A;
Owen, CG;
Anderson, J;
Warwick, AN;
Chambers, R;
Bolter, L;
Wu, Y;
Welikala, R;
Fajtl, J;
Barman, SA;
et al.
Olvera-Barrios, A; Owen, CG; Anderson, J; Warwick, AN; Chambers, R; Bolter, L; Wu, Y; Welikala, R; Fajtl, J; Barman, SA; Remagnino, P; Chew, EY; Ferris, FL; Hingorani, AD; Sofat, R; Lee, AY; Egan, C; Tufail, A; Rudnicka, AR; ARIAS Research Group
(2023)
Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study.
BMJ Open Diabetes Res Care, 11 (6).
e003683.
ISSN 2052-4897
https://doi.org/10.1136/bmjdrc-2023-003683
SGUL Authors: Owen, Christopher Grant Rudnicka, Alicja Regina
Abstract
INTRODUCTION: The English Diabetic Eye Screening Programme (DESP) offers people living with diabetes (PLD) annual eye screening. We examined incidence and determinants of sight-threatening diabetic retinopathy (STDR) in a sociodemographically diverse multi-ethnic population. RESEARCH DESIGN AND METHODS: North East London DESP cohort data (January 2012 to December 2021) with 137 591 PLD with no retinopathy, or non-STDR at baseline in one/both eyes, were used to calculate STDR incidence rates by sociodemographic factors, diabetes type, and duration. HR from Cox models examined associations with STDR. RESULTS: There were 16 388 incident STDR cases over a median of 5.4 years (IQR 2.8-8.2; STDR rate 2.214, 95% CI 2.214 to 2.215 per 100 person-years). People with no retinopathy at baseline had a lower risk of sight-threatening diabetic retinopathy (STDR) compared with those with non-STDR in one eye (HR 3.03, 95% CI 2.91 to 3.15, p<0.001) and both eyes (HR 7.88, 95% CI 7.59 to 8.18, p<0.001). Black and South Asian individuals had higher STDR hazards than white individuals (HR 1.57, 95% CI 1.50 to 1.64 and HR 1.36, 95% CI 1.31 to 1.42, respectively). Additionally, every 5-year increase in age at inclusion was associated with an 8% reduction in STDR hazards (p<0.001). CONCLUSIONS: Ethnic disparities exist in a health system limited by capacity rather than patient economic circumstances. Diabetic retinopathy at first screen is a strong determinant of STDR development. By using basic demographic characteristics, screening programmes or clinical practices can stratify risk for sight-threatening diabetic retinopathy development.
Item Type: |
Article
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Additional Information: |
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
Keywords: |
blindness, diabetic retinopathy, ethnic groups, healthcare disparities, Humans, Retrospective Studies, Diabetic Retinopathy, Mass Screening, Incidence, London, Diabetes Mellitus, 1103 Clinical Sciences |
SGUL Research Institute / Research Centre: |
Academic Structure > Population Health Research Institute (INPH) |
Journal or Publication Title: |
BMJ Open Diabetes Res Care |
ISSN: |
2052-4897 |
Language: |
eng |
Dates: |
Date | Event |
---|
10 November 2023 | Published | 8 September 2023 | Accepted |
|
Publisher License: |
Creative Commons: Attribution 4.0 |
Projects: |
|
PubMed ID: |
37949472 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/115868 |
Publisher's version: |
https://doi.org/10.1136/bmjdrc-2023-003683 |
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