Risk factors for diabetic retinopathy in self-reported rural population with diabetes.

BACKGROUND Diabetes and its related microvascular complications like diabetic retinopathy (DR) are showing increased prevalence in India. However, the magnitude of DR in rural population with diabetes needs exploration. AIM To estimate the prevalence and risk factors for the presence and severity of diabetic retinopathy in the self-reported rural population with diabetes. SETTINGS AND DESIGN In a cross-sectional study, a total of 26,519 participants (age >or= 30 years) attended 198 diabetic retinopathy screening camps conducted in three southern districts of Tamilnadu, India, between February 2004 and April 2006. MATERIALS AND METHODS All the participants underwent a dilated eye examination to detect DR by indirect ophthalmoscopy. Systemic and ocular risk factor estimation was done in a comprehensive examination. STATISTICAL ANALYSIS Univariate and stepwise regression analyses were done to identify the independent risk factors associated with the presence and severity of retinopathy. RESULTS The prevalence of diabetic retinopathy was 17.6% among the self-reported rural population with diabetes. The prevalence of referable (sight threatening) retinopathy was 5.3%. Risk factors associated with the development of any DR were male gender (OR= 1.37), longer duration of diabetes (per year, OR= 1.07), lean body mass index (OR= 1.30), higher systolic blood pressure (per 10 mm Hg, OR= 1.18), and insulin treatment (OR= 1.34; P P CONCLUSION: The study identified risk factors associated with DR in the rural population with diabetes. The results suggested that there was a need for formulating effective preventive strategies to minimize avoidable blindness due to diabetes, in rural areas.