Diabetic retinopathy is responsible for approximately 15% of blindness in the United States. Among Blacks, the prevalence of diabetes is high and the incidence increasing; thus, diabetic retinopathy and associated visual impairment represents a major public health problem for the U.S. Black population. The overall goal of this study is to ascertain factors for developing severe diabetic retinopathy (in order ultimately to identify patients who are likely to develop the condition), in Blacks with type I (insulin dependent) diabetes mellitus. In order to achieve this goal, we will investigate the frequency of diabetic retinopathy using a graded classification scheme, and relate retinopathy severity levels to several specific risk factors. We hypothesize that presence and severity levels of diabetic retinopathy in diabetic Blacks are significantly associated with five putative risk factors: longer duration of disease, female gender, poor glycemic control, high blood pressure, and low socioeconomic status. The patient population for our study will be comprised of type I diabetic Black patients, as identified from the New Jersey Hospital Discharge Data. Clinical evaluation of patients will include ocular examination, fundus photography, a structured clinical interview, and a dietary questionnaire. Laboratory evaluation will include measurement of blood and urine samples to assess glycemic control, insulin insufficiency, diabetic renal disease, and blood antioxidant levels. Presence and severity levels of diabetic retinopathy will be related to the risk factors identified above. Diabetic retinopathy among Black diabetics is a condition in dire need of investigation. Our proposed studies will yield the first comprehensive data on severity levels of diabetic retinopathy and contributive risk factors in type I Black diabetic patients. Furthermore, it is expected that these data will provide a basis for public health education strategies and treatment modalities to prevent or reduce severity of diabetic retinopathy in all diabetic patients.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
1R01EY009860-01
Application #
3267213
Study Section
Visual Sciences A Study Section (VISA)
Project Start
1992-12-01
Project End
1997-11-30
Budget Start
1992-12-01
Budget End
1993-11-30
Support Year
1
Fiscal Year
1993
Total Cost
Indirect Cost
Name
University of Medicine & Dentistry of NJ
Department
Type
Schools of Medicine
DUNS #
605799469
City
Newark
State
NJ
Country
United States
Zip Code
07107
Roy, Monique S; Janal, Malvin N; Crosby, Juan et al. (2015) Markers of endothelial dysfunction and inflammation predict progression of diabetic nephropathy in African Americans with type 1 diabetes. Kidney Int 87:427-33
Roy, Monique S; Janal, Malvin N; Crosby, Juan et al. (2013) Inflammatory biomarkers and progression of diabetic retinopathy in African Americans with type 1 diabetes. Invest Ophthalmol Vis Sci 54:5471-80
Roy, Monique S; Klein, Ronald; Janal, Malvin N (2012) Relationship of retinal vessel caliber to cardiovascular disease and mortality in African Americans with type 1 diabetes mellitus. Arch Ophthalmol 130:561-7
Yau, Joanne W Y; Rogers, Sophie L; Kawasaki, Ryo et al. (2012) Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 35:556-64
Roy, Monique S; Klein, Ronald; Janal, Malvin N (2011) Retinal venular diameter as an early indicator of progression to proliferative diabetic retinopathy with and without high-risk characteristics in African Americans with type 1 diabetes mellitus. Arch Ophthalmol 129:8-15
Roy, Alec; Roy, Monique; Janal, Malvin (2010) Suicide attempts and ideation in African-American type 1 diabetic patients. Psychiatry Res 179:53-6
Roy, Monique S; Janal, Malvin N (2010) High caloric and sodium intakes as risk factors for progression of retinopathy in type 1 diabetes mellitus. Arch Ophthalmol 128:33-9
Roy, M S; Peng, B (2008) Six-year incidence of lower extremity arterial disease and associated risk factors in Type 1 diabetic African-Americans. Diabet Med 25:550-6
Roy, M S; Peng, B; Roy, A (2007) Risk factors for coronary disease and stroke in previously hospitalized African-Americans with Type 1 diabetes: a 6-year follow-up. Diabet Med 24:1361-8
Roy, Monique S; Roy, Alec; Affouf, Mahmoud (2007) Depression is a risk factor for poor glycemic control and retinopathy in African-Americans with type 1 diabetes. Psychosom Med 69:537-42

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