Development of Proliferative Diabetic Retinopathy in African-Americans and Whites With Type 1 Diabetes

OBJECTIVE — To investigate the comparable risk of developing proliferative diabetic retinopathy (PDR) in African-Americans and whites with type 1 diabetes. RESEARCH DESIGN AND METHODS — Using a cohort design with the sample drawn from medical records, the sample consisted of 312 people with type 1 diabetes (97 African-Americans, 215 whites) having at least two visits to a Model Demonstration Unit with gradeable fundus photographs (stereo, color, 7 standard fields). Excluded were subjects with preexisting or treated PDR or hemoglobinopathy. Masked grading of the fundus photographs was conducted at the Wisconsin Reading Center. RESULTS — At baseline, African-Americans had poorer glycemic control (mean HbAj of 11.3 vs. 10.0%, P < 0.0001), higher systolic blood pressure (mean of 117 vs. 110 mmHg, P < 0.001), and were older (mean of 26.8 vs. 19.3 years, P < 0.0001) than the white subjects. African-Americans also tended to have slightly longer duration of diabetes and length of fol-low-up. In the African-Americans, 17.5 % developed PDR, compared with 10.2 % in the 215 whites, for an odds ratio (OR) of 1.86 (95 % CI 0.93-3.70). When adjusted for baseline glycemic control, retinopathy grade, and length of follow-up, race was not a significant risk fac