Diabetic retinopathy among Brazilian Xavante Indians

Author(s)

Lima, Carlos Gustavo M. G. ^[1] ; Franco, Laercio Joel ^[2] ; Dal Fabbro, Amaury L. ^[2] ; Martinez, Edson Z. ^[2] ; Botelho Veira-Filho, Joao Paulo ^[3] ; Ventura, Alexandre A. C. M. ^[4] ; Prevelato, Leonardo ^[1] ; Cruz, Antonio Augusto V. ^[1]

Affiliation

^[1] Univ Sao Paulo, Dept Ophthalmol Otorhinolaryngol & Head & Neck Su, Ribeirao Preto Med Sch, Ave Bandeirantes 3900, BR-14049900 Ribeirao Preto, SP - Brazil

^[2] Univ Sao Paulo, Dept Social Med, Ribeirao Preto Med Sch, BR-14049900 Ribeirao Preto, SP - Brazil

^[3] Univ Fed Sao Paulo, Sao Paulo Med Sch, Div Endocrinol, BR-04038001 Sao Paulo, SP - Brazil

^[4] Fernando Ventura Eye Inst, Dept Ophthalmol, BR-52010140 Recife, PE - Brazil

• Document type: Journal article
• Source: DIABETOLOGY & METABOLIC SYNDROME; v. 10, JUN 13 2018.
• Web of Science Citations: 0

Abstract

Background: To describe the frequency of diabetic retinopathy (DR) and its associated variables in Brazilian Xavante Indians. Methods: A population-based survey carried out in two Xavante Reservations between 2008 and 2012, included 948 Indians aged 20 years or more, identified 246 individuals with type 2 diabetes. A non-probabilistic cluster sample of 140 diabetic individuals were submitted to ophthalmologic examination. Due to operational conditions and to optimize the field work, only the larger Xavante villages were included. Ophthalmologic examinations were performed during one trip to each reservation, in their villages and consisted of measurement visual acuity, anterior segment biomicroscopy, applanation tonometry, and direct and indirect ophthalmoscopy. Results: The frequency of DR was 19.3%, distributed as follows: mild non-proliferative retinopathy in nine (33.3%) subjects, moderate in nine (33.3%), severe in six (22.3%), very severe in two (7.4%), and high-risk proliferative DR in one (3.7%). The occurrence of DR was higher among those with a longer duration of diabetes, higher levels of glycated hemoglobin (HbA1c) and fasting glucose, papillary excavation >= 0.5, and among individuals in older age group. Using the log-binomial regression model, diabetes duration >24 months and HbA1c >= 6.5% were significantly associated with the occurrence of DR. Conclusions: The presence of DR (19.3%) in Xavante Indians is an alert for health care providers for this population, since diabetes is a new disease among them. Its association with disease duration, high levels of HbA1c and blood glucose calls attention for the necessity of more actions to improve diabetes control in this recently contacted ethnic group that needs particular attention. (AU)

• FAPESP's process: 10/05634-0 - Diabetes mellitus and associated diseases in the adult Xavante population of the Indian Reservation of São Marcos - MT
• Grantee: Laercio Joel Franco
• Support type: Regular Research Grants