Undiagnosed Diabetes and Related Eye Disease in Mexican-Americans -- A Call for Increased Detection
This News Release is Available in Spanish at:
http://www.nih.gov/news/pr/jun2001/nei-22a.htm
A research study of the Mexican-American population over
age 40 found that the rate of diabetes in this group is 20
percent -- almost twice that of non-Hispanic Whites -- and
that 15 percent of those with diabetes did not know that
they had the disease before their participation in the
study. The findings suggest that increased efforts to
improve diabetes detection in Mexican-Americans may be
warranted. These data are reported in a research paper
published in the July 2001 issue of "Diabetes Care", a
journal of the American Diabetes Association.
Of the 15 percent who were newly diagnosed with diabetes,
23 percent had early to moderate diabetic retinopathy, a
potentially blinding eye complication of diabetes, and
another nine percent had advanced diabetic retinopathy and
were in immediate danger of losing some vision. The study
was sponsored by the National Eye Institute (NEI) and the
National Center on Minority Health and Health Disparities
(NCMHD), components of the Federal government's National
Institutes of Health (NIH).
"These findings serve as a 'red flag,'" said Paul Sieving,
M.D., Ph.D., director of the NEI. "The longer a person has
untreated diabetes, the more likely the disease will cause
complications.
In fact, diabetes increases the risk of blindness 25-fold
over the general population. People
with diabetes should be encouraged to seek regular eye care
to increase the chances of early detection and timely
treatment of diabetic eye disease."
"Untreated diabetes can lead to devastating complications,"
said John Ruffin Ph.D., NCMHD director. "These findings
underscore the importance of early diagnosis and treatment,
especially in minority populations who suffer from a
disproportionately high prevalence of Type 2 diabetes."
"The onset of diabetes in the survey's newly diagnosed
group was most likely between four to seven years earlier,"
according to Sheila West, Ph.D., El-Maghraby Professor of
Preventive Ophthalmology at Johns Hopkins University School
of Medicine in Baltimore and lead author of the paper. "It
is important that diabetes be detected early, so it can be
controlled before complications appear." Previous studies
sponsored by the National Institute of Diabetes and
Digestive and Kidney Disease at the NIH have shown that
people with diabetes who keep their blood sugar,
cholesterol, and blood pressure levels as close to normal
as possible have much less vision loss, heart disease,
kidney, and nerve damage.
"With early detection, timely laser surgery, and
appropriate follow-up care, people with advanced diabetic
retinopathy can reduce their risk of blindness by 90
percent," Dr. Sieving said. "But if people do not realize
they have diabetes, their blood sugar levels may be high
enough to cause vision loss and other complications before
they receive appropriate medical care."
The study of the Mexican-American population also found
that:
- The rate of diabetes in the Mexican-American community
age 40 years and older was 20 percent, rising from 10
percent in those aged 40-49, to 32 percent in those aged
70-79. This high prevalence of diabetes among Hispanics of
Mexican origin -- generally 2-21/2 times higher compared to
non-Hispanic Whites -- is similar to that reported by other
studies.
- The rate of diabetic retinopathy in those with diabetes
was 48 percent, a number similar to that of non-Hispanic
Whites. Prior to the survey, there had been conflicting
reports about the rate of diabetic retinopathy in Mexican-
Americans with diabetes. In this survey, it is estimated
that one-third of Mexican-Americans with diabetic
retinopathy could have delayed or prevented eye
complications with early detection and control of their
diabetes.
- The rate of diabetic retinopathy increased with higher
blood sugar levels and longer duration of diabetes.
The study -- called "Proyecto VER (Vision Evaluation and
Research)" -- assessed visual impairment in a population-
based sample of 4500 Mexican-Americans age 40 and older
living in Tucson and Nogales, Arizona. "Proyecto VER" was
designed to address the prevalence and causes of visual
impairment including diabetic retinopathy in this
population group. In the United States, the Mexican-
American population is the second largest minority group,
and if current trends continue, will become the largest
minority group during this century.
About 16 million people in the United States have diabetes,
the most common cause of blindness, kidney failure, and
amputations in adults. One-third of people with diabetes do
not know they have it. Type 2 diabetes, which accounts for
about 90 percent of diabetes in the US, is most common in
people who are overweight, inactive, over age 40, and have
a family history of diabetes. The disease is also more
common in minorities; African Americans, Hispanic/Latino
Americans, Native Americans, and some Asian Americans and
Pacific Islanders are at especially high risk.
People with Type 2 diabetes first develop insulin
resistance, a disorder in which muscle, fat, and liver
cells do not use insulin properly. At first, the pancreas
compensates by producing more insulin, but gradually its
capacity to secrete insulin in response to meals falters,
and the timing of insulin secretion is abnormal. After
diabetes develops, pancreatic production of insulin
continues to decline. Many people can control their blood
glucose by following a careful diet and exercise program,
losing excess weight, and taking oral medication. However,
the longer a person has Type 2 diabetes, the more likely he
or she will need insulin injections, either alone or
combined with oral medications.
About 5-10 percent, or one million people with diabetes,
have Type 1, formerly known as juvenile onset diabetes or
insulin-dependent diabetes. This form of diabetes, which
usually occurs in children and adults under age 30,
develops when the body's immune system attacks the insulin-
producing cells of the pancreas.
The National Eye Institute (NEI), the Federal government's
lead agency for vision research, is part of the National
Institutes of Health (NIH) under the US Department of
Health and Human Services. NEI-supported research leads to
sight-saving treatments and plays a key role in reducing
visual impairment and blindness.
The NIH's National Center on Minority Health and Health
Disparities (NCMHD) conducts and supports research,
training, information dissemination and other programs
aimed at reducing the disproportionately high incidence and
prevalence of disease, burden of illness, and mortality
experienced by certain American populations, including
racial and ethnic minorities and other groups with
disparate health status, such as the urban and rural poor.
B-Roll and PSA's Available in English and Spanish at 301-496-5248.