Latinos at great risk of developing diabetes-related vision issues, study finds
BETHESDA, Md. Latinos have higher rates of developing visual impairment, blindness, diabetic eye disease and cataracts than non-Hispanic whites, researchers that were part of the "Los Angeles Latino Eye Study" have found. According to a press release issued by the National Eye Institute on Saturday, these are the first estimates of visual impairment and eye disease development in Latinos.
"This study showed that Latinos develop certain vision conditions at different rates than other ethnic groups," stated Rohit Varma, principal investigator of LALES and director of the Ocular Epidemiology Center at the Doheny Eye Institute, University of Southern California. "The burden of vision loss and eye disease on the Latino community is increasing as the population ages, and many eye diseases are becoming more common."
LALES began in 2000 as the nation’s largest and most comprehensive study of vision in Latinos. In the current phase of LALES, researchers examined more than 4,600 Latinos four years after they initially enrolled in the study to determine the development of new eye disease and the progression of existing conditions, including visual impairment, blindness, diabetic eye disease, age-related macular degeneration, and cataracts.
Participants were mainly of Mexican descent, age 40 years and older, and living in the city of La Puente, Los Angeles County, Calif. Study results were published in four papers in the May issue of the American Journal of Ophthalmology.
"These data have significant public health implications and present a challenge for eye care providers to develop programs to address the burden of eye disease in Latinos," stated NEI director Paul Sieving. "NEI has a strong record of commitment to educating the Latino community and healthcare providers about eye diseases through its National Eye Health Education Program, and will continue to make this a priority."
LALES researchers found that over the four-year interval, Latinos developed visual impairment and blindness at the highest rate of any ethnic group in the country, when compared with estimates from other U.S. population-based studies. Overall, nearly 3% of Latinos developed visual impairment and 0.3% developed blindness in both eyes, with older adults impacted more frequently. Of Latinos age 80 years and older, 19.4% became visually impaired, and 3.8% became blind in both eyes.
U.S. Latinos also were more likely to develop diabetic retinopathy than non-Hispanic whites. Over the four-year period, 34% of Latinos who had diabetes developed diabetic retinopathy, with Latinos ages 40 to 59 years having the highest rate. Though increasing age did not play a role, Latinos with a longer duration of diabetes were more likely to develop the disease. In fact, 42% of Latinos with diabetes for more than 15 years developed diabetic retinopathy. Also, among participants who had diabetic retinopathy at the beginning of the study, 39% showed worsening of the disease four years later.
Researchers found that Latinos who already had visual impairment, blindness, or diabetic retinopathy in one eye when they began the study had very high rates of developing the condition in the other eye during the study. More than half of participants who already had diabetic retinopathy in one eye developed it in the other eye.
"These results underscore the importance of Latinos, especially those with diabetes, getting regular, dilated eye exams to monitor their eye health," Varma said. "Eye care professionals should closely monitor Latinos who have eye disease in one eye because their quality of life can be dramatically impacted if they develop the condition in both eyes."
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Study: Vitamin B may decrease kidney function in diabetic nephropathy patients
NEW YORK Patients with a kidney disease caused by diabetes that receive high-dose vitamin B therapy are more likely to have decreased kidney function and an increased risk of heart attack and stroke, a new study found.
Published in the Apr. 28 issue of the Journal of the American Medical Association, Andrew House, M.D., of the University of Western Ontario, and J. David Spence, M.D., of the Robarts Research Institute, London, Ontario, and colleagues conducted a study to examine whether B-vitamin therapy would slow the progression of diabetic nephropathy and prevent vascular events in 238 patients with Type 1 or 2 diabetes. Data taken from patients in the randomized, placebo-controlled trial between May 2001 and May 2007 found the measure of kidney function — radionuclide glomerular filtration rate, or GFR — rapidly decreased in those who consumed vitamin B6 and B12, between baseline and 36 months, compared with the placebo group. Additionally, the researchers found that risk of such cardiovascular events as heart attack, stroke, revascularization, and all-cause mortality, doubled in the B-vitamin group.
Meanwhile, House, Spence and colleagues also added that they tested the patients’ levels of homocysteine, a naturally occurring amino acid found in blood plasma. While high levels of homocysteine are more likely to cause heart attack and other diseases, the researchers noted that participants in the B-vitamin group had an average decrease while participants in the placebo group had an average increase. This result, the authors concluded, should not necessarily be a guide for those interested in testing this theory outside of a clinical trial.
"Given the recent large-scale clinical trials showing no treatment benefit, and our trial demonstrating harm, it would be prudent to discourage the use of high-dose B vitamins as a homocysteine-lowering strategy outside the framework of properly conducted clinical research," the authors concluded.