African Caribbean people with type 1 diabetes at greater risk of losing sight

Cross-partnership study adds much-needed evidence to show the relationship between ethnicity and type 1 diabetes-related retinopathy.

African Caribbean people with type 1 diabetes have a 39% greater risk of developing sight-threatening diabetic retinopathy, which if untreated can lead to blindness.

The cross-partnership study, published in Diabetes Care, was led by researchers from King’s College London and funded by Guy’s and St Thomas’ Charity. It involved joint work with teams from Guy’s and St Thomas’ and King’s College Hospital NHS Foundation Trusts (NHS FT).

The findings add much-needed evidence to show the relationship between ethnicity and type 1 diabetes-related retinopathy.

Diabetic retinopathy is caused by high blood sugar levels damaging the retina, which is located at the back of the eye. It can take years for diabetic retinopathy to threaten eyesight if not diagnosed and treated. Diabetic retinopathy is the leading cause of blindness in working age people in the UK and many other countries.

The study followed a diverse population group from south London over six years who had type 1 diabetes but no signs of retinopathy. By the end of study, they found African Caribbean ethnicity is a risk factor for sight-threatening diabetic retinopathy, even when adjusted for traditional risk predictors such glucose control and blood pressure as well as socioeconomic status. The study also found the African Caribbean and the Caucasian group, which had the least risk, attended the same number of eye screenings.

Researchers warn that more thorough eye exams are needed for at-risk groups.

Janaka Karalliedde, Clinical Reader in Diabetes and Cardiovascular Disease at King’s College London, said: 

We undertook this study because there is no previous studies in people with type 1 diabetes of the potential impact of ethnicity on diabetic retinopathy. Our novel observation that people with type 1 diabetes of African Caribbean ethnicity are at 39% greater risk of sight threating retinopathy independent of conventional risk factors suggests that enhanced retinal surveillance and risk factor control may be needed in such higher risk groups.

Hilary Nathan, policy director at JDRF, the type 1 diabetes charity said:

Sight loss is devastating. This is important research because it helps us begin to understand how rates of type 1 diabetes disease progression can be more aggressive across different ethnicity patient populations. Findings like these can help evidence and design more personalised treatment pathways helping to prevent sight loss and disability.

Diabetic Eye Screening Programme

In November last year KHP spoke to Consultant Ophthalmologist Samantha Mann about the South East London Diabetic Eye Screening Programme at Guy's and St Thomas' NHS FT. She described the significant risk of blindless for people with diabetes, and the work the Trust is doing to detect the warning signs early.

Watch the video interview here:

(1) An introduction to the South East London Diabetic Eye Screening Programme - YouTube

The KHP Diabetes, Endocrinology, and Obesity teams works to improve health and wellbeing for people living with diabetes, obesity and endocrine disorders across London, south east England and beyond. Visit its webpages here.