Impact of socioeconomic deprivation on the development of diabetic retinopathy: a population-based, cross-sectional and longitudinal study over 12 years.
Bottom Line: Increased prevalence of DR in type 1 DM was associated with higher overall SIMD score (p=0.002), with an OR for the most deprived relative to the least deprived of 2.40 (95% CI 1.36 to 4.27).In type 2 DM, the overall SIMD score was not significantly associated with increased prevalence of DR, with an OR for the most deprived relative to the least deprived of 0.85 (95% CI 0.71 to 1.02, p=0.07).Socioeconomic deprivation is associated with increased prevalence of DR in patients with type 1 DM and this occurs earlier.
Affiliation: Academic Unit of Ophthalmology, University of Birmingham, Birmingham and Midland Eye Centre, Birmingham, UK.Show MeSH
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Mentions: The median time from diagnosis of DM to onset of retinopathy (R1) in patients with type 1 DM from the most deprived areas was 9.1 years as opposed to more than 12 years in all other quintiles (p<0.001; figure 1). The 10 years retinopathy-free survival for patients with type 1 DM in the most deprived areas was 40.6% compared with 66.7% for patients from the least deprived areas. A Cox regression model, accounting for age and gender, returned a HR of 2.16 (95% CI 1.27 to 3.69) for the most deprived, relative to the least deprived quintile (p<0.001). For the remainder of the deprivation quintiles, retinopathy hazards were similar. Hence, the increased risk of retinopathy appears to be mainly confined to the 0–20% most deprived group of patients (table 4).
Affiliation: Academic Unit of Ophthalmology, University of Birmingham, Birmingham and Midland Eye Centre, Birmingham, UK.