Tamara Thomas

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The number of new cases and progression of diabetic retinopathy (DR) is lower than the figures reported 30 years ago for American Indian and Alaska Native individuals, according to a study published in JAMA Ophthalmology.
For this study, Dr. Stephanie Fonda and colleagues used medical data from different routine clinical operations of the Indian Health Service (IHS) teleophthalmology program in 20 US states to determine the clinical levels of DR and diabetic macular edema (DME) severity.
The study was conducted from January 1 to December 31, 2015, with a follow-up period of January 1, 2016, to December 31, 2019. Participants included people with diabetes aged 20 or older who had no evidence of DR or mild nonproliferative diabetic retinopathy (NPDR) at the start of the study. The study excluded patients with severe NPDR, proliferative DR, or DME.
The study included 8374 American Indian and Alaska Native individuals, of which 57% were women. The mean age of the participants is 53. Most patients in the study have had diabetes for more than seven years, with more than half of the population managing their diabetes with oral medication alone.
The researchers observed that of the study participants who had no signs of diabetic retinopathy at the start of the study, 18% developed some retinopathy at follow-up. In addition, 65.5% of the cases observed were mild NPDR. The findings also reveal that the cumulative incidence of proliferative diabetic retinopathy (PDR) was 0.1%, and 6.2% of patients had a step increase in DR of 2 or more.
Furthermore, the researchers found that more than 27% of the patients with mild NPDR at the start of the study had developed a more severe form of DR after follow-up, with 2.3% experiencing a step increase of 2 or more. They also found the cumulative incidence of severe/very severe NPDR in this population was 0.2%, and proliferative DR was 2.2%.
“The estimates reported here are lower than previous estimates in American Indian and Alaska Native patients. Estimates from this study are also lower than or similar to estimates of DR incidence in Hispanic American individuals.” the researchers write.
The researchers concluded that the incidence and progression of DR in AI/AN individuals was lower than 30 years ago, thus narrowing the gap in DR incidence between AI/AN individuals and other populations.
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Source:<a href="https://www.ajmc.com/view/estimates-of-diabetic-retinopathy-incidence-progression-lower-than-previously-reported-in-american-indians"> AJMC</a>
Journal Source:<a href="https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2802373"> JAMA Ophthalmology</a>

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“The estimates reported ... are lower than previous estimates in American Indian and Alaska Native patients."

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