www.diabeticretinopathy.org.uk

Epidemiology

David Kinshuck

 

Predictive Index (PI) above 36 predicts retinopathy

The HbA1 value above 42mmol/ 6% was calculated for each year of diabetes. A value of 36 indicates retinopathy might be present Hirose 2012. So a patient with an Hba1c of 1% for eleven years, will have a PI = 44,  (11 years; HbA1c 10 (actual, versus ideal 6: 10-6 = 4); 10 x 4 = 40) and be very likely to have retinopathy.

Note

Homocysteine

We need low homocycsteine levels...these are lower with a diet with plenty of vegetables. Sem 14 . See how to lower levels.

 

Decreasing incidence of nephropathy and retinopathy in type 1 diabetes

P Hovind et al

Figures for 2011  indicated 25% of diabetics have retiopathy, and this is severe in 8%.

 

Impaired glucose tolerance and diabetes and retinopathy

H A van Leiden

Prevalence of retinopathy

 

Risk factors for retinopathy, E Bandurska-Stankiewicz, EASDec meeting 2002, notes

Education was the main risk factor. Other factors were similar to those discussed generally elsewhere on this site.

 

Other details

 

Progression

Of 85 patients in 1990 with proliferative diabetic retinopathy, 57 deteriorated. If categorised in 1990 with 4 microaneurysms or less, patients generally did better versus the other with more that 4 microaneurysms. Thus even after laser for proliferation, the degree of maculopathy (as indicated by number of microaneurySsms) indicates the prognosis. (Denmark, EASDec 2003, Bek &J Kjaergaard).

 

Incidence of retinopathy

These studies here and here indicate that about 12% of people with diabetes are undergoing laser treatment of have had some in the past. But some diabetologists report much lower rates, perhaps 1%, probably because their patients have much better controlled diabetes. 7% of patients presenting with diabetes have retinopathy at presentation...does this represent a failure of screening for diabetes?

 

Low socio-economic status

This is a major risk factor, see  Poor reading skills and educational achievement make retinopathy much more likely. See other papers.  Some communities have very high retinopathy rates, here. Good care improves outcomes in the US.

Visual impairment in Cambridge    Leeds   70 blind registrations/year/1,000,000 UK

 

Type 1: 25 years, Wisonconsin results

After 25 years of diabetes, there is

 

Erectile dysfunction is common

See

 

Late diagnosis 

This is very common, even in wealthy areas such as North Birmingham. 15% of patients have retinopathy at presentation, and diabetes may have been present 5-9 years previously BJO 11

This paper indicates there is no simple cut off point for the diagnosis of diabetes; 'detectable retinopathy occurs 5.77 years before diagnosis. (This is not the serious retinopahy that needs laser...that takes a few  years longer to develop.

 

Tunisia 

Tunisia Eye 14