ArticleBMJ open2025
Differences in prevalence and risk factors of diabetic retinopathy among rural and urban residents with diabetes in South China: a cross-sectional study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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19 authors.
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Abstract
objectiveTo determine the prevalence of diabetic retinopathy (DR) and associated risk factors among rural and urban people diagnosed with type 1 or type 2 diabetes mellitus (PwDM) in southern China.
designThis is a cross-sectional study.
settingThe study was conducted at primary health centres from 2 September to the end of December 2019.
participantsAll the 3646 PwDM being registered in Qujiang District, aged ≥18 years were informed, of whom 2677 attended the screening and were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES: The presence of DR was determined by trained graders using criteria of the UK National Health Service Diabetic Eye Screening Programme. Multiple logistic regression analyses were used to assess potential risk factors for the presence of DR.
resultsThe mean age of the participants (73.4% of the 3646 invited people) was 63.4 years (SD 10.1 years), 1503 (56.2%) were female, 1749 (65.3%) were rural residents, 1654 (71.0%) participants had glycated haemoglobin (HbA1c)≥6.5%, 1773 (66.3%) had high blood pressure and the median duration of diabetes mellitus (DM) was <5 years. Although half (52.0%) of these participants had brief (<5 years) exposure to DM, 831 (31.3%, 95% CI: 29.3 to 32.8%) had DR, among whom 412 (49.6%) had sight-threatening DR. Men (33.1%) had a significantly higher prevalence of any DR than women (29.4%, p<0.05). There were no significant differences in DR prevalence at any level between rural and urban residents. In multivariate regression models, risk factors for any DR were HbA1c>6.5% (OR=1.58, p<0.01), using insulin and antihyperglycaemic medications (OR=1.76, p<0.01), longer duration of DM and higher systolic blood pressure (OR=1.01 for each mm Hg, p<0.01).
conclusionsThe high prevalence of DR, hyperglycaemia and high blood pressure highlight the need for better management of non-communicable diseases in China.
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