Associations with sight-threatening diabetic macular oedema among Indigenous adults with type 2 diabetes attending an Indigenous primary care clinic in remote Australia: a Centre of Research Excellence in Diabetic Retinopathy and Telehealth Eye and Associated Medical Services Network study

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dc.contributor.authorBrazionis, L.
dc.contributor.authorKeech, A.
dc.contributor.authorRyan, C.
dc.contributor.authorBrown, A.
dc.contributor.authorO'Neal, D.
dc.contributor.authorBoffa, J.
dc.contributor.authorBursell, S.E.
dc.contributor.authorJenkins, A.
dc.date.issued2021
dc.description.abstractObjective To identify factors associated with sight-threatening diabetic macular oedema (STDM) in Indigenous Australians attending an Indigenous primary care clinic in remote Australia. Methods and analysis A cross-sectional study design of retinopathy screening data and routinely-collected clinical data among 236 adult Indigenous participants with type 2 diabetes (35.6% men) set in one Indigenous primary care clinic in remote Australia. The primary outcome variable was STDM assessed from retinal images. Results Age (median (range)) was 48 (21–86) years, and known diabetes duration (median (range)) was 8.0 (0–24) years. Prevalence of STDM was high (14.8%) and similar in men and women. STDM was associated with longer diabetes duration (11.7 vs 7.9 years, respectively; p<0.001) and markers of renal impairment: abnormal estimated Glomerular Filtration Rate (eGFR) (62.9 vs 38.3%, respectively; p=0.007), severe macroalbuminuria (>300 mg/mmol) (20.6 vs 5.7%, respectively; p=0.014) and chronic kidney disease (25.7 vs 12.2%, respectively; p=0.035). Some clinical factors differed by sex: anaemia was more prevalent in women. A higher proportion of men were smokers, prescribed statins and had increased albuminuria. Men had higher blood pressure, but lower glycated Haemoglobin A1c (HbA1c) levels and body mass index, than women. Conclusion STDM prevalence was high and similar in men and women. Markers of renal impairment and longer diabetes duration were associated with STDM in this Indigenous primary care population. Embedded teleretinal screening, known diabetes duration-based risk stratification and targeted interventions may lower the prevalence of STDM in remote Indigenous primary care services.Trial registration number Australia and New Zealand Clinical Trials Register: ACTRN 12616000370404.
dc.description.statementofresponsibilityLaima Brazioni, Anthony Keech, Christopher Ryan, Alex Brown, David O'Neal, John Boffa, Sven-Erik Bursell, Alicia Jenkins
dc.identifier.citationBMJ Open Ophthalmology, 2021; 6(1):1-10
dc.identifier.doi10.1136/bmjophth-2020-000559
dc.identifier.issn2397-3269
dc.identifier.issn2397-3269
dc.identifier.orcidBrown, A. [0000-0003-2112-3918]
dc.identifier.urihttps://hdl.handle.net/2440/132903
dc.language.isoen
dc.publisherBMJ Journals
dc.relation.grantNHMRC
dc.rights© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.source.urihttps://doi.org/10.1136/bmjophth-2020-000559
dc.subjectepidemiology
dc.subjectimaging
dc.subjectmacula
dc.subjectpathology
dc.subjectpublic health
dc.subjectretina
dc.subjecttelemedicine
dc.subjectvision
dc.titleAssociations with sight-threatening diabetic macular oedema among Indigenous adults with type 2 diabetes attending an Indigenous primary care clinic in remote Australia: a Centre of Research Excellence in Diabetic Retinopathy and Telehealth Eye and Associated Medical Services Network study
dc.typeJournal article
pubs.publication-statusPublished

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