OBJECTIVETo examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes.RESEARCH DESIGN AND METHODSA pooled analysis using individual participant data from population-based studies around the world was performed. A systematic literature review was conducted to identify all population-based studies in general populations or individuals with diabetes who had ascertained DR from retinal photographs. Studies provided data for DR end points, including any DR, proliferative DR, diabetic macular edema, and VTDR, and also major systemic risk factors. Pooled prevalence estimates were directly age-standardized to the 2010 World Diabetes Population aged 20–79 years.RESULTSA total of 35 studies (1980–2008) provided data from 22,896 individuals with diabetes. The overall prevalence was 34.6% (95% CI 34.5–34.8) for any DR, 6.96% (6.87–7.04) for proliferative DR, 6.81% (6.74–6.89) for diabetic macular edema, and 10.2% (10.1–10.3) for VTDR. All DR prevalence end points increased with diabetes duration, hemoglobin A1c, and blood pressure levels and were higher in people with type 1 compared with type 2 diabetes.CONCLUSIONSThere are approximately 93 million people with DR, 17 million with proliferative DR, 21 million with diabetic macular edema, and 28 million with VTDR worldwide. Longer diabetes duration and poorer glycemic and blood pressure control are strongly associated with DR. These data highlight the substantial worldwide public health burden of DR and the importance of modifiable risk factors in its occurrence. This study is limited by data pooled from studies at different time points, with different methodologies and population characteristics.

OBJECTIVE -The aim of this study was to determine the prevalence of diabetic nephropathy among urban Asian-Indian type 2 diabetic subjects.RESEARCH DESIGN AND METHODS -Type 2 diabetic subjects (n ϭ 1,716), inclusive of known diabetic subjects (KD subjects) (1,363 of 1,529; response rate 89.1%) and randomly selected newly diagnosed diabetic subjects (NDD subjects) (n ϭ 353) were selected from the Chennai Urban Rural Epidemiology Study (CURES). Microalbuminuria was estimated by immunoturbidometric assay and diagnosed if albumin excretion was between 30 and 299 g/mg of creatinine, and overt nephropathy was diagnosed if albumin excretion was Ն300 g/mg of creatinine in the presence of diabetic retinopathy, which was assessed by stereoscopic retinal color photography.RESULTS -The prevalence of overt nephropathy was 2.2% (95% CI 1.51-2.91). Microalbuminuria was present in 26. 9% (24.8 -28.9). Compared with the NDD subjects, KD subjects had greater prevalence rates of both microalbuminuria with retinopathy and overt nephropathy (8.4 vs. 1.4%, P Ͻ 0.001; and 2.6 vs. 0.8%, P ϭ 0.043, respectively). Logistic regression analysis showed that A1C (odds ratio 1.325 [95% CI 1.256 -1.399], P Ͻ 0.001), smoking (odds ratio 1.464, P ϭ 0.011), duration of diabetes (1.023, P ϭ 0.046), systolic blood pressure (1.020, P Ͻ 0.001), and diastolic blood pressure (1.016, P ϭ 0.022) were associated with microalbuminuria. A1C (1.483, P Ͻ 0.0001), duration of diabetes (1.073, P ϭ 0.003), and systolic blood pressure (1.031, P ϭ 0.004) were associated with overt nephropathy.CONCLUSIONS -The results of the study suggest that in urban Asian Indians, the prevalence of overt nephropathy and microalbuminuria was 2.2 and 26.9%, respectively. Duration of diabetes, A1C, and systolic blood pressure were the common risk factors for overt nephropathy and microalbuminuria. Diabetes Care 30:2019-2024, 2007D iabetic nephropathy is the leading cause of end-stage renal disease (ESRD) worldwide, and it is estimated that ϳ20% of type 2 diabetic patients reach ESRD during their lifetime (1). Kidney disease in diabetic patients is clinically characterized by increasing rates of urinary albumin excretion, starting from normoalbuminuria, which progresses to microalbuminuria, macroalbuminuria, and eventually to ESRD. Microalbuminuria is the earliest clinically detectable stage of diabetic kidney disease at which appropriate interventions can retard, or reverse, the progress of the disease.According to the most recent estimates published in the Diabetes Atlas 2006 (2), India has the largest number of diabetic patients in the world, estimated to be ϳ40.9 million in the year 2007 and expected to increase to ϳ69.9 million by the year 2025. Type 2 diabetes in Asian Indians differs from that in Europeans in several aspects: the onset is at a younger age, obesity is less common, and genetic factors appear to be more common (3). Some studies (4 -6) conducted in migrant Asian Indians in the U.K. and Europe have reported increased prevalence of diabetic nephropathy compared wit...

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The data suggests that serum Lp(a) is an independent risk factor for CAD in NIDDM patients in South India.