Eye disease often progresses in blacks with diabetes

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Over a 6-year period, 56 percent of African Americans with type 1 diabetes and retinopathy, a common diabetes-related complication that can lead to blindness if unchecked, showed progression of their eye disease, according to a report in the Archives of Ophthalmology. Poor blood sugar and blood pressure control were identified as risk factors for progression.

The findings stem from a study of 483 patients who were part of The New Jersey 725 cohort, which comprised African-Americans who were diagnosed with diabetes and treated with insulin before 30 years of age. The study group included only those with type 1 diabetes, also known as juvenile diabetes. Patient interviews, eye exams and blood pressure measurements were taken at the beginning of the study and 6 years later.

After 6 years, 72 percent of the patients at risk for eye disease had developed diabetic retinopathy, report Dr. Monique S. Roy, from the University of Medicine and Dentistry in Newark, and Dr. Mahmoud Affouf, from Kean University in Union, both in New Jersey.

As noted, 56 percent of the patients with retinopathy at the beginning of the study had disease progression, which included extensive retinopathy in 15 percent and macular edema—fluid accumulation in part of the retina responsible for central vision—in 16 percent.

High blood sugar levels and blood pressure at the start of the trial were significant predictors of retinopathy progression and macular edema, the team found.

Older age, kidney disease, and severe retinopathy all correlated with progression to proliferative retinopathy. For macular edema, the risk factors included older age, lower socioeconomic status, severe retinopathy, and high total cholesterol levels.

Because control of blood sugar and blood pressure in this patient population tends to be poor, ways of improving medical care and ensuring regular eye exams may reduce this vision-threatening complication of diabetes, the authors conclude.

SOURCE: Archives of Opthalmology, September 2006.

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