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Published in: BMC Ophthalmology 1/2014

Open Access 01-12-2014 | Research article

Prevalence of retinopathy among adults with self-reported diabetes mellitus: the Sri Lanka diabetes and Cardiovascular Study

Authors: Prasad Katulanda, Priyanga Ranasinghe, Ranil Jayawardena

Published in: BMC Ophthalmology | Issue 1/2014

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Abstract

Background

At present there are no large scale nationally-representative studies from Sri Lanka on the prevalence and associations of Diabetic Retinopathy (DR). The present study aims to evaluate the prevalence and risk factors for DR in a community-based nationally-representative sample of adults with self-reported diabetes mellitus from Sri Lanka.

Methods

A cross-sectional community-based national study among 5,000 adults (≥18 years) was conducted in Sri Lanka, using a multi-stage stratified cluster sampling technique. An interviewer-administered questionnaire was used to collect data. Ophthalmological evaluation of patients with ‘known’ diabetes (previously diagnosed at a government hospital or by a registered medical practitioner) was done using indirect ophthalmoscopy. A binary-logistic regression analysis was performed with ‘presence of DR’ as the dichotomous dependent variable and other independent covariates.

Results

Crude prevalence of diabetes was 12.0% (n = 536), of which 344 were patients with ‘known’ diabetes. Mean age was 56.4 ± 10.9 years and 37.3% were males. Prevalence of any degree of DR was 27.4% (Males-30.5%, Females-25.6%; p = 0.41). In patients with DR, majority had NPDR (93.4%), while 5.3% had maculopathy. Patients with DR had a significantly longer duration of diabetes than those without. In the binary-logistic regression analysis in all adults duration of diabetes (OR:1.07), current smoking (OR:1.67) and peripheral neuropathy (OR:1.72) all were significantly associated with DR.

Conclusions

Nearly 1/3rd of Sri Lankan adults with self-reported diabetes are having retinopathy. DR was associated with diabetes duration, cigarette smoking and peripheral neuropathy. However, further prospective follow up studies are required to establish causality for identified risk factors.
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Literature
1.
go back to reference Adeghate E, Schattner P, Dunn E: An update on the etiology and epidemiology of diabetes mellitus. Ann N Y Acad Sci. 2006, 1084: 1-29. 10.1196/annals.1372.029.CrossRefPubMed Adeghate E, Schattner P, Dunn E: An update on the etiology and epidemiology of diabetes mellitus. Ann N Y Acad Sci. 2006, 1084: 1-29. 10.1196/annals.1372.029.CrossRefPubMed
2.
go back to reference International Diabetes Federation: Diabetes Atlas. 2013, Brussels: International Diabetes Federation, Editor International Diabetes Federation: Diabetes Atlas. 2013, Brussels: International Diabetes Federation, Editor
3.
go back to reference American Academy of Ophthalmology: Preferred Practice Pattern: Diabetic Retinopathy. 1998, San Francisco: American Academy of Ophthalmology American Academy of Ophthalmology: Preferred Practice Pattern: Diabetic Retinopathy. 1998, San Francisco: American Academy of Ophthalmology
4.
go back to reference World Health Organization: Global Data on Visual Impairment. 2012, Geneva: WHO, 1-17. World Health Organization: Global Data on Visual Impairment. 2012, Geneva: WHO, 1-17.
5.
go back to reference Singh R, Ramasamy K, Abraham C, Gupta V, Gupta A: Diabetic retinopathy: an update. Indian J Ophthalmol. 2008, 56 (3): 178-188.PubMed Singh R, Ramasamy K, Abraham C, Gupta V, Gupta A: Diabetic retinopathy: an update. Indian J Ophthalmol. 2008, 56 (3): 178-188.PubMed
6.
go back to reference Stratton IM, Kohner EM, Aldington SJ, Turner RC, Holman RR, Manley SE, Matthews DR: UKPDS 50: risk factors for incidence and progression of retinopathy in type II diabetes over 6 years from diagnosis. Diabetologia. 2001, 44 (2): 156-163. 10.1007/s001250051594.CrossRefPubMed Stratton IM, Kohner EM, Aldington SJ, Turner RC, Holman RR, Manley SE, Matthews DR: UKPDS 50: risk factors for incidence and progression of retinopathy in type II diabetes over 6 years from diagnosis. Diabetologia. 2001, 44 (2): 156-163. 10.1007/s001250051594.CrossRefPubMed
7.
go back to reference Jayawardena R, Ranasinghe P, Byrne NM, Soares MJ, Katulanda P, Hills AP: Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis. BMC Public Health. 2012, 12: 380-10.1186/1471-2458-12-380.CrossRefPubMedPubMedCentral Jayawardena R, Ranasinghe P, Byrne NM, Soares MJ, Katulanda P, Hills AP: Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis. BMC Public Health. 2012, 12: 380-10.1186/1471-2458-12-380.CrossRefPubMedPubMedCentral
8.
go back to reference Chowdhury TA, Lasker SS: Complications and cardiovascular risk factors in South Asians and Europeans with early-onset type 2 diabetes. QJM. 2002, 95 (4): 241-246. 10.1093/qjmed/95.4.241.CrossRefPubMed Chowdhury TA, Lasker SS: Complications and cardiovascular risk factors in South Asians and Europeans with early-onset type 2 diabetes. QJM. 2002, 95 (4): 241-246. 10.1093/qjmed/95.4.241.CrossRefPubMed
9.
go back to reference Pardhan S, Gilchrist J, Mahomed I: Impact of age and duration on sight-threatening retinopathy in South Asians and Caucasians attending a diabetic clinic. Eye (Lond). 2004, 18 (3): 233-240. 10.1038/sj.eye.6700629.CrossRef Pardhan S, Gilchrist J, Mahomed I: Impact of age and duration on sight-threatening retinopathy in South Asians and Caucasians attending a diabetic clinic. Eye (Lond). 2004, 18 (3): 233-240. 10.1038/sj.eye.6700629.CrossRef
10.
go back to reference Pradeepa R, Anitha B, Mohan V, Ganesan A, Rema M: Risk factors for diabetic retinopathy in a South Indian Type 2 diabetic population–the Chennai Urban Rural Epidemiology Study (CURES) Eye Study 4. Diabet Med. 2008, 25 (5): 536-542. 10.1111/j.1464-5491.2008.02423.x.CrossRefPubMed Pradeepa R, Anitha B, Mohan V, Ganesan A, Rema M: Risk factors for diabetic retinopathy in a South Indian Type 2 diabetic population–the Chennai Urban Rural Epidemiology Study (CURES) Eye Study 4. Diabet Med. 2008, 25 (5): 536-542. 10.1111/j.1464-5491.2008.02423.x.CrossRefPubMed
11.
go back to reference Prospective UK, Diabetes Study Group: UK Prospective Diabetes Study. XII: Differences between Asian, Afro-Caribbean and white Caucasian type 2 diabetic patients at diagnosis of diabetes. UK Prospective Diabetes Study Group. Diabet Med. 1994, 11 (7): 670-677.CrossRef Prospective UK, Diabetes Study Group: UK Prospective Diabetes Study. XII: Differences between Asian, Afro-Caribbean and white Caucasian type 2 diabetic patients at diagnosis of diabetes. UK Prospective Diabetes Study Group. Diabet Med. 1994, 11 (7): 670-677.CrossRef
12.
go back to reference Fernando DJ, Siribaddana S, De S, Subasinge Z: Prevalence of retinopathy in a Sri Lankan diabetes clinic. Ceylon Med J. 1993, 38 (3): 120-123.PubMed Fernando DJ, Siribaddana S, De S, Subasinge Z: Prevalence of retinopathy in a Sri Lankan diabetes clinic. Ceylon Med J. 1993, 38 (3): 120-123.PubMed
13.
go back to reference Katulanda P, Constantine GR, Mahesh JG, Sheriff R, Seneviratne RDA, Wijeratne S, Wijesuriya M, McCarthy MI, Adler AI, Matthews DR: Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka—Sri Lanka Diabetes, Cardiovascular Study (SLDCS). Diabet Med. 2008, 25 (9): 1062-1069. 10.1111/j.1464-5491.2008.02523.x.CrossRefPubMed Katulanda P, Constantine GR, Mahesh JG, Sheriff R, Seneviratne RDA, Wijeratne S, Wijesuriya M, McCarthy MI, Adler AI, Matthews DR: Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka—Sri Lanka Diabetes, Cardiovascular Study (SLDCS). Diabet Med. 2008, 25 (9): 1062-1069. 10.1111/j.1464-5491.2008.02523.x.CrossRefPubMed
14.
go back to reference World Health Organization: Report of a WHO Expert Committee: Physical Status: The Use And Interpretation Of Anthropometry. World Health Organ Technical Report Series. 1995, Geneva: WHO, 1-452. World Health Organization: Report of a WHO Expert Committee: Physical Status: The Use And Interpretation Of Anthropometry. World Health Organ Technical Report Series. 1995, Geneva: WHO, 1-452.
15.
go back to reference Jayawardana R, Ranasinghe P, Sheriff MH, Matthews DR, Katulanda P: Waist to height ratio: a better anthropometric marker of diabetes and cardio-metabolic risks in South Asian adults. Diabetes Res Clin Pract. 2013, 99 (3): 292-299. 10.1016/j.diabres.2012.12.013.CrossRefPubMed Jayawardana R, Ranasinghe P, Sheriff MH, Matthews DR, Katulanda P: Waist to height ratio: a better anthropometric marker of diabetes and cardio-metabolic risks in South Asian adults. Diabetes Res Clin Pract. 2013, 99 (3): 292-299. 10.1016/j.diabres.2012.12.013.CrossRefPubMed
16.
go back to reference American Diabetes Association: Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997, 20 (7): 1183-1197.CrossRef American Diabetes Association: Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997, 20 (7): 1183-1197.CrossRef
17.
go back to reference World Health Organization: Part 1: Diagnosis and Classification of Diabetes Mellitus. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. 1999, Geneva: WHO World Health Organization: Part 1: Diagnosis and Classification of Diabetes Mellitus. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. 1999, Geneva: WHO
18.
go back to reference WHO Expert Consultation: Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004, 363 (9403): 157-163.CrossRef WHO Expert Consultation: Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004, 363 (9403): 157-163.CrossRef
20.
go back to reference Perkins BA, Olaleye D, Zinman B, Bril V: Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes Care. 2001, 24 (2): 250-256. 10.2337/diacare.24.2.250.CrossRefPubMed Perkins BA, Olaleye D, Zinman B, Bril V: Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes Care. 2001, 24 (2): 250-256. 10.2337/diacare.24.2.250.CrossRefPubMed
21.
go back to reference Wilkinson CP, Ferris FL, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT, Global Diabetic Retinopathy Project Group: Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003, 110 (9): 1677-1682. 10.1016/S0161-6420(03)00475-5.CrossRefPubMed Wilkinson CP, Ferris FL, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT, Global Diabetic Retinopathy Project Group: Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003, 110 (9): 1677-1682. 10.1016/S0161-6420(03)00475-5.CrossRefPubMed
22.
go back to reference Weerasuriya N, Siribaddana S, Dissanayake A, Subasinghe Z, Wariyapola D, Fernando DJ: Long-term complications in newly diagnosed Sri Lankan patients with type 2 diabetes mellitus. QJM. 1998, 91 (6): 439-443. 10.1093/qjmed/91.6.439.CrossRefPubMed Weerasuriya N, Siribaddana S, Dissanayake A, Subasinghe Z, Wariyapola D, Fernando DJ: Long-term complications in newly diagnosed Sri Lankan patients with type 2 diabetes mellitus. QJM. 1998, 91 (6): 439-443. 10.1093/qjmed/91.6.439.CrossRefPubMed
23.
go back to reference Katulanda P, Waniganayake YC, Ranasinghe P, Wijetunga WMUA, Jayaweera M, Wijesinghe NP, Sheriff R, Matthews DR: Retinopathy among young adults with diabetes mellitus from a tertiary care setting in Sri Lanka. BMC Endocr Disord. 2014, 14: 20-10.1186/1472-6823-14-20.CrossRefPubMedPubMedCentral Katulanda P, Waniganayake YC, Ranasinghe P, Wijetunga WMUA, Jayaweera M, Wijesinghe NP, Sheriff R, Matthews DR: Retinopathy among young adults with diabetes mellitus from a tertiary care setting in Sri Lanka. BMC Endocr Disord. 2014, 14: 20-10.1186/1472-6823-14-20.CrossRefPubMedPubMedCentral
24.
go back to reference Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, Chen SJ, Dekker JM, Fletcher A, Grauslund J, Haffner S, Hamman RF, Ikram MK, Kayama T, Klein BE, Klein R, Krishnaiah S, Mayurasakorn K, O’Hare JP, Orchard TJ, Porta M, Rema M, Roy MS, Sharma T, Shaw J, Taylor H, Tielsch JM, Varma R, Wang JJ: Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012, 35 (3): 556-564. 10.2337/dc11-1909.CrossRefPubMedPubMedCentral Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, Chen SJ, Dekker JM, Fletcher A, Grauslund J, Haffner S, Hamman RF, Ikram MK, Kayama T, Klein BE, Klein R, Krishnaiah S, Mayurasakorn K, O’Hare JP, Orchard TJ, Porta M, Rema M, Roy MS, Sharma T, Shaw J, Taylor H, Tielsch JM, Varma R, Wang JJ: Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012, 35 (3): 556-564. 10.2337/dc11-1909.CrossRefPubMedPubMedCentral
25.
go back to reference Akhter A, Fatema K, Ahmed SF, Afroz A, Ali L, Hussain A: Prevalence and associated risk indicators of retinopathy in a rural Bangladeshi population with and without diabetes. Ophthalmic Epidemiol. 2013, 20 (4): 220-227. 10.3109/09286586.2013.809770.CrossRefPubMed Akhter A, Fatema K, Ahmed SF, Afroz A, Ali L, Hussain A: Prevalence and associated risk indicators of retinopathy in a rural Bangladeshi population with and without diabetes. Ophthalmic Epidemiol. 2013, 20 (4): 220-227. 10.3109/09286586.2013.809770.CrossRefPubMed
26.
go back to reference Rema M, Premkumar S, Anitha B, Deepa R, Pradeepa R, Mohan V: Prevalence of diabetic retinopathy in urban India: the Chennai Urban Rural Epidemiology Study (CURES) eye study, I. Invest Ophthalmol Vis Sci. 2005, 46 (7): 2328-2333. 10.1167/iovs.05-0019.CrossRefPubMed Rema M, Premkumar S, Anitha B, Deepa R, Pradeepa R, Mohan V: Prevalence of diabetic retinopathy in urban India: the Chennai Urban Rural Epidemiology Study (CURES) eye study, I. Invest Ophthalmol Vis Sci. 2005, 46 (7): 2328-2333. 10.1167/iovs.05-0019.CrossRefPubMed
27.
go back to reference Namperumalsamy P, Kim R, Vignesh TP, Nithya N, Royes J, Gijo T, Thulasiraj RD, Vijayakumar V: Prevalence and risk factors for diabetic retinopathy: a population-based assessment from Theni District, south India. Postgrad Med J. 2009, 85 (1010): 643-648. 10.1136/bjo.2008.147934.CrossRefPubMed Namperumalsamy P, Kim R, Vignesh TP, Nithya N, Royes J, Gijo T, Thulasiraj RD, Vijayakumar V: Prevalence and risk factors for diabetic retinopathy: a population-based assessment from Theni District, south India. Postgrad Med J. 2009, 85 (1010): 643-648. 10.1136/bjo.2008.147934.CrossRefPubMed
28.
go back to reference Raman R, Rani PK, Reddi Rachepalle S, Gnanamoorthy P, Uthra S, Kumaramanickavel G, Sharma T: Prevalence of diabetic retinopathy in India: Sankara Nethralaya diabetic retinopathy epidemiology and molecular genetics study Report 2. Ophthalmology. 2009, 116 (2): 311-318. 10.1016/j.ophtha.2008.09.010.CrossRefPubMed Raman R, Rani PK, Reddi Rachepalle S, Gnanamoorthy P, Uthra S, Kumaramanickavel G, Sharma T: Prevalence of diabetic retinopathy in India: Sankara Nethralaya diabetic retinopathy epidemiology and molecular genetics study Report 2. Ophthalmology. 2009, 116 (2): 311-318. 10.1016/j.ophtha.2008.09.010.CrossRefPubMed
29.
go back to reference Shrestha MK, Paudyal G, Wagle RR, Gurung R, Ruit S, Onta SR: Prevalence of and factors associated with diabetic retinopathy among diabetics in Nepal: a hospital based study. Nepal Med Coll J. 2007, 9 (4): 225-229.PubMed Shrestha MK, Paudyal G, Wagle RR, Gurung R, Ruit S, Onta SR: Prevalence of and factors associated with diabetic retinopathy among diabetics in Nepal: a hospital based study. Nepal Med Coll J. 2007, 9 (4): 225-229.PubMed
30.
go back to reference Paudyal G, Shrestha MK, Meyer JJ, Thapa R, Gurung R, Ruit S: Prevalence of diabetic retinopathy following a community screening for diabetes. Nepal Med Coll J. 2008, 10 (3): 160-163.PubMed Paudyal G, Shrestha MK, Meyer JJ, Thapa R, Gurung R, Ruit S: Prevalence of diabetic retinopathy following a community screening for diabetes. Nepal Med Coll J. 2008, 10 (3): 160-163.PubMed
31.
go back to reference Shrestha RK: Ocular manifestations in diabetes, a hospital based prospective study. Nepal Med Coll J. 2011, 13 (4): 254-256.PubMed Shrestha RK: Ocular manifestations in diabetes, a hospital based prospective study. Nepal Med Coll J. 2011, 13 (4): 254-256.PubMed
32.
go back to reference Mahar PS, Awan MZ, Manzar N, Memon MS: Prevalence of type-II diabetes mellitus and diabetic retinopathy: the Gaddap study. J Coll Physicians Surg Pak. 2010, 20 (8): 528-532.PubMed Mahar PS, Awan MZ, Manzar N, Memon MS: Prevalence of type-II diabetes mellitus and diabetic retinopathy: the Gaddap study. J Coll Physicians Surg Pak. 2010, 20 (8): 528-532.PubMed
33.
go back to reference Hussain F, Arif M, Ahmad M: The prevalence of diabetic retinopathy in Faisalabad, Pakistan: a population-based study. Turkish J Med Sci. 2011, 41 (4): 735-742. Hussain F, Arif M, Ahmad M: The prevalence of diabetic retinopathy in Faisalabad, Pakistan: a population-based study. Turkish J Med Sci. 2011, 41 (4): 735-742.
34.
go back to reference Shaikh MA, Gillani S, Dur EY: Frequency of diabetic retinopathy in patients after ten years of diagnosis of type 2 diabetes mellitus. J Ayub Med Coll Abbottabad. 2010, 22 (3): 158-160.PubMed Shaikh MA, Gillani S, Dur EY: Frequency of diabetic retinopathy in patients after ten years of diagnosis of type 2 diabetes mellitus. J Ayub Med Coll Abbottabad. 2010, 22 (3): 158-160.PubMed
35.
go back to reference Moss SE, Klein R, Klein BE: Cigarette smoking and ten-year progression of diabetic retinopathy. Ophthalmology. 1996, 103 (9): 1438-1442. 10.1016/S0161-6420(96)30486-7.CrossRefPubMed Moss SE, Klein R, Klein BE: Cigarette smoking and ten-year progression of diabetic retinopathy. Ophthalmology. 1996, 103 (9): 1438-1442. 10.1016/S0161-6420(96)30486-7.CrossRefPubMed
36.
go back to reference Moss SE, Klein R, Klein BE: Association of cigarette smoking with diabetic retinopathy. Diabetes Care. 1991, 14 (2): 119-126. 10.2337/diacare.14.2.119.CrossRefPubMed Moss SE, Klein R, Klein BE: Association of cigarette smoking with diabetic retinopathy. Diabetes Care. 1991, 14 (2): 119-126. 10.2337/diacare.14.2.119.CrossRefPubMed
37.
go back to reference Paetkau ME, Boyd TA, Winship B, Grace M: Cigarette smoking and diabetic retinopathy. Diabetes. 1977, 26 (1): 46-49. 10.2337/diab.26.1.46.CrossRefPubMed Paetkau ME, Boyd TA, Winship B, Grace M: Cigarette smoking and diabetic retinopathy. Diabetes. 1977, 26 (1): 46-49. 10.2337/diab.26.1.46.CrossRefPubMed
38.
go back to reference Katulanda P, Ranasinghe P, Jayawardena R, Constantine GR, Sheriff MH, Matthews DR: The prevalence, patterns and predictors of diabetic peripheral neuropathy in a developing country. Diabetol Metab Syndr. 2012, 4 (1): 21-10.1186/1758-5996-4-21.CrossRefPubMedPubMedCentral Katulanda P, Ranasinghe P, Jayawardena R, Constantine GR, Sheriff MH, Matthews DR: The prevalence, patterns and predictors of diabetic peripheral neuropathy in a developing country. Diabetol Metab Syndr. 2012, 4 (1): 21-10.1186/1758-5996-4-21.CrossRefPubMedPubMedCentral
39.
go back to reference Fong DS, Warram JH, Aiello LM, Rand LI, Krolewski AS: Cardiovascular autonomic neuropathy and proliferative diabetic retinopathy. Am J Ophthalmol. 1995, 120 (3): 317-321.CrossRefPubMed Fong DS, Warram JH, Aiello LM, Rand LI, Krolewski AS: Cardiovascular autonomic neuropathy and proliferative diabetic retinopathy. Am J Ophthalmol. 1995, 120 (3): 317-321.CrossRefPubMed
40.
go back to reference Katusic D, Tomic M, Jukic T, Kordic R, Sikic J, Vukojevic N, Saric B: Obesity–a risk factor for diabetic retinopathy in type 2 diabetes?. Coll Antropol. 2005, 29 (Suppl 1): 47-50.PubMed Katusic D, Tomic M, Jukic T, Kordic R, Sikic J, Vukojevic N, Saric B: Obesity–a risk factor for diabetic retinopathy in type 2 diabetes?. Coll Antropol. 2005, 29 (Suppl 1): 47-50.PubMed
41.
go back to reference Smith TS, Szetu J, Bourne RR: The prevalence and severity of diabetic retinopathy, associated risk factors and vision loss in patients registered with type 2 diabetes in Luganville, Vanuatu. Br J Ophthalmol. 2007, 91 (4): 415-419. 10.1136/bjo.2006.104174.CrossRefPubMed Smith TS, Szetu J, Bourne RR: The prevalence and severity of diabetic retinopathy, associated risk factors and vision loss in patients registered with type 2 diabetes in Luganville, Vanuatu. Br J Ophthalmol. 2007, 91 (4): 415-419. 10.1136/bjo.2006.104174.CrossRefPubMed
42.
go back to reference UK Prospective Diabetes Study Group: Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998, 317 (7160): 703-713. 10.1136/bmj.317.7160.703.CrossRefPubMedCentral UK Prospective Diabetes Study Group: Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998, 317 (7160): 703-713. 10.1136/bmj.317.7160.703.CrossRefPubMedCentral
43.
go back to reference Garg S, Davis RM: Diabetic retinopathy screening update. Clin Diabetes. 2009, 27: 140-145. 10.2337/diaclin.27.4.140.CrossRef Garg S, Davis RM: Diabetic retinopathy screening update. Clin Diabetes. 2009, 27: 140-145. 10.2337/diaclin.27.4.140.CrossRef
Metadata
Title
Prevalence of retinopathy among adults with self-reported diabetes mellitus: the Sri Lanka diabetes and Cardiovascular Study
Authors
Prasad Katulanda
Priyanga Ranasinghe
Ranil Jayawardena
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2014
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/1471-2415-14-100

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