Diabetes and Nonrefractive Visual Impairment The Young Have It Diabetes and Nonrefractive Visual Impairment

Musch DC, Gardner TW. — Wed, 12 Dec 2012 00:00:00 GMT

Type 2 diabetes mellitus, a disease most commonly encountered in older obese persons, has become endemic in teenagers and young adults. Evidence for the increasing incidence of type 2 diabetes in youth and adolescents has been well documented. Given the known risk of complications from diabetes, an increase in the prevalence of these complications over time would be expected among younger diabetics. In this issue of JAMA, Ko and colleagues provide evidence that this is likely happening in the US population.

Prevalence of Nonrefractive Visual Impairment in US Adults and Associated Risk Factors, 1999-2002 and 2005-2008 Nonrefractive Visual Impairment in US Adults

Ko F, Vitale S, Chou C, et al. — Wed, 12 Dec 2012 00:00:00 GMT

Context

Over the past decade, chronic illnesses with ophthalmic sequelae such as diabetes and diabetic retinopathy have increased.

Objectives

To estimate prevalence of nonrefractive visual impairment and to describe its relationship with demographic and systemic risk factors including diagnosed diabetes.

Design, Setting, and Participants

The National Health and Nutrition Examination Survey (NHANES) examined a representative sample of the US noninstitutionalized population. In 1999-2002 and 2005-2008, 9471 and 10 480 participants aged 20 years or older received questionnaires, laboratory tests, and physical examinations. Visual acuity of less than 20/40 aided by autorefractor was classified as nonrefractive visual impairment.

Main Outcome Measure

Nonrefractive visual impairment.

Results

Weighted prevalence of nonrefractive visual impairment increased 21% among US adults aged 20 years and older from 1.4% in 1999-2002 to 1.7% in 2005-2008 (P = .03); and increased 40% among non-Hispanic whites aged 20-39 years from 0.5% to 0.7% (P = .008). In multivariable analyses, statistically significant risk factors for nonrefractive visual impairment in 1999-2002 included age (per year odds ratio [OR], 1.07; 95% CI, 1.05-1.09), poverty (OR, 2.18; 95% CI, 1.31-3.64), lack of insurance (OR, 1.85; 95% CI, 1.16-2.95), and diabetes with 10 or more years since diagnosis (OR, 1.93; 95% CI, 1.15-3.25). In 2005-2008, risk factors included age (OR, 1.05; 95% CI, 1.04-1.07), poverty (OR, 2.23; 95% CI, 1.55-3.22), education less than high school (OR, 2.11; 95% CI, 1.54-2.90), and diabetes with 10 or more years since diagnosis (OR, 2.67; 95% CI, 1.64-4.37). Prevalence of diabetes with 10 or more years since diagnosis increased 22% overall from 2.8% to 3.6% (P = .02); and 133% among non-Hispanic whites aged 20-39 years from 0.3% to 0.7% (P < .001).

Conclusion

Prevalence of nonrefractive visual impairment was significantly higher in 2005-2008 than in 1999-2002 and may be attributable, in part, to higher prevalence of diabetes, an associated risk factor that increased in prevalence during this time period.

JAMA: Diabetic Retinopathy Topic Collection

Diabetes and Nonrefractive Visual Impairment The Young Have It Diabetes and Nonrefractive Visual Impairment

Prevalence of Nonrefractive Visual Impairment in US Adults and Associated Risk Factors, 1999-2002 and 2005-2008 Nonrefractive Visual Impairment in US Adults