Development of proliferative diabetic retinopathy in African-Americans and whites with type 1 diabetes

Cynthia L. Arfken, Philip L. Reno, Julio V. Santiago, Ronald Klein

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

OBJECTIVE - To investigate the comparable risk of developing proliferative diabetic retinopathy (PDR) in African-Americans and whites with type 1 diabetes. RESEARCH DESIGN AND METHODS - Using a cohort design with the sample drawn from medical records, the sample consisted of 312 people with type 1 diabetes (97 African-Americans, 215 whites) having at least two visits to a Model Demonstration Unit with gradeable fundus photographs (stereo, color, 7 standard fields). Excluded were subjects with preexisting or treated PDR or hemoglobinopathy. Masked grading of the fundus photographs was conducted at the Wisconsin Reading Center. RESULTS - At baseline, African- Americans had poorer glycemic control (mean HbA1 of 11.3 vs. 10.0%, P < 0.0001), higher systolic blood pressure (mean of 117 vs. 110 mmHg, P < 0.001), and were older (mean of 26.8 vs. 19.3 years, P < 0.0001) than the white subjects. African-Americans also tended to have slightly longer duration of diabetes and length of follow-up. In the African-Americans, 17.5% developed PDR, compared with 10.2% in the 215 whites, for an odds ratio (OR) of 1.86 (95% CI 0.93-3.70). When adjusted for baseline glycemic control, retinopathy grade, and length of follow-up, race was not a significant risk factor (OR = 0.73, 95% CI 0.30-1.78). CONCLUSIONS - African-Americans with type 1 diabetes may have a higher rate of developing PDR. The observed racial difference, however, is attributable to the presence of a worse risk factor profile, especially to poorer glycemic control. Efforts should be expanded to improve the care for all individuals with poor glycemic control.

Original languageEnglish (US)
Pages (from-to)792-795
Number of pages4
JournalDiabetes care
Volume21
Issue number5
DOIs
StatePublished - Nov 5 1998

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Diabetic Retinopathy
Type 1 Diabetes Mellitus
African Americans
Odds Ratio
Hemoglobinopathies
Glycosylated Hemoglobin A
Medical Records
Reading
Research Design
Color
Blood Pressure
Hypertension

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Arfken, Cynthia L. ; Reno, Philip L. ; Santiago, Julio V. ; Klein, Ronald. / Development of proliferative diabetic retinopathy in African-Americans and whites with type 1 diabetes. In: Diabetes care. 1998 ; Vol. 21, No. 5. pp. 792-795.
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abstract = "OBJECTIVE - To investigate the comparable risk of developing proliferative diabetic retinopathy (PDR) in African-Americans and whites with type 1 diabetes. RESEARCH DESIGN AND METHODS - Using a cohort design with the sample drawn from medical records, the sample consisted of 312 people with type 1 diabetes (97 African-Americans, 215 whites) having at least two visits to a Model Demonstration Unit with gradeable fundus photographs (stereo, color, 7 standard fields). Excluded were subjects with preexisting or treated PDR or hemoglobinopathy. Masked grading of the fundus photographs was conducted at the Wisconsin Reading Center. RESULTS - At baseline, African- Americans had poorer glycemic control (mean HbA1 of 11.3 vs. 10.0{\%}, P < 0.0001), higher systolic blood pressure (mean of 117 vs. 110 mmHg, P < 0.001), and were older (mean of 26.8 vs. 19.3 years, P < 0.0001) than the white subjects. African-Americans also tended to have slightly longer duration of diabetes and length of follow-up. In the African-Americans, 17.5{\%} developed PDR, compared with 10.2{\%} in the 215 whites, for an odds ratio (OR) of 1.86 (95{\%} CI 0.93-3.70). When adjusted for baseline glycemic control, retinopathy grade, and length of follow-up, race was not a significant risk factor (OR = 0.73, 95{\%} CI 0.30-1.78). CONCLUSIONS - African-Americans with type 1 diabetes may have a higher rate of developing PDR. The observed racial difference, however, is attributable to the presence of a worse risk factor profile, especially to poorer glycemic control. Efforts should be expanded to improve the care for all individuals with poor glycemic control.",
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Development of proliferative diabetic retinopathy in African-Americans and whites with type 1 diabetes. / Arfken, Cynthia L.; Reno, Philip L.; Santiago, Julio V.; Klein, Ronald.

In: Diabetes care, Vol. 21, No. 5, 05.11.1998, p. 792-795.

Research output: Contribution to journalArticle

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N2 - OBJECTIVE - To investigate the comparable risk of developing proliferative diabetic retinopathy (PDR) in African-Americans and whites with type 1 diabetes. RESEARCH DESIGN AND METHODS - Using a cohort design with the sample drawn from medical records, the sample consisted of 312 people with type 1 diabetes (97 African-Americans, 215 whites) having at least two visits to a Model Demonstration Unit with gradeable fundus photographs (stereo, color, 7 standard fields). Excluded were subjects with preexisting or treated PDR or hemoglobinopathy. Masked grading of the fundus photographs was conducted at the Wisconsin Reading Center. RESULTS - At baseline, African- Americans had poorer glycemic control (mean HbA1 of 11.3 vs. 10.0%, P < 0.0001), higher systolic blood pressure (mean of 117 vs. 110 mmHg, P < 0.001), and were older (mean of 26.8 vs. 19.3 years, P < 0.0001) than the white subjects. African-Americans also tended to have slightly longer duration of diabetes and length of follow-up. In the African-Americans, 17.5% developed PDR, compared with 10.2% in the 215 whites, for an odds ratio (OR) of 1.86 (95% CI 0.93-3.70). When adjusted for baseline glycemic control, retinopathy grade, and length of follow-up, race was not a significant risk factor (OR = 0.73, 95% CI 0.30-1.78). CONCLUSIONS - African-Americans with type 1 diabetes may have a higher rate of developing PDR. The observed racial difference, however, is attributable to the presence of a worse risk factor profile, especially to poorer glycemic control. Efforts should be expanded to improve the care for all individuals with poor glycemic control.

AB - OBJECTIVE - To investigate the comparable risk of developing proliferative diabetic retinopathy (PDR) in African-Americans and whites with type 1 diabetes. RESEARCH DESIGN AND METHODS - Using a cohort design with the sample drawn from medical records, the sample consisted of 312 people with type 1 diabetes (97 African-Americans, 215 whites) having at least two visits to a Model Demonstration Unit with gradeable fundus photographs (stereo, color, 7 standard fields). Excluded were subjects with preexisting or treated PDR or hemoglobinopathy. Masked grading of the fundus photographs was conducted at the Wisconsin Reading Center. RESULTS - At baseline, African- Americans had poorer glycemic control (mean HbA1 of 11.3 vs. 10.0%, P < 0.0001), higher systolic blood pressure (mean of 117 vs. 110 mmHg, P < 0.001), and were older (mean of 26.8 vs. 19.3 years, P < 0.0001) than the white subjects. African-Americans also tended to have slightly longer duration of diabetes and length of follow-up. In the African-Americans, 17.5% developed PDR, compared with 10.2% in the 215 whites, for an odds ratio (OR) of 1.86 (95% CI 0.93-3.70). When adjusted for baseline glycemic control, retinopathy grade, and length of follow-up, race was not a significant risk factor (OR = 0.73, 95% CI 0.30-1.78). CONCLUSIONS - African-Americans with type 1 diabetes may have a higher rate of developing PDR. The observed racial difference, however, is attributable to the presence of a worse risk factor profile, especially to poorer glycemic control. Efforts should be expanded to improve the care for all individuals with poor glycemic control.

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