The prevalence of diabetic retinopathy among Pacific populations in the Counties Manukau DHB region, New Zealand

Abstract

Introduction: With life expectancies increasing worldwide and the rates of diabetes reaching epidemic proportions, it has been predicted that diabetic retinopathy (DR) may become the leading cause of visual impairment globally. Currently, little is known about the prevalence of DR among the Pacific Populations living in NZ. Wagner’s chronic care model emphasises the benefits of information systems in helping capture the burden of conditions such as diabetes. Aims: To describe the prevalence of diabetes mellitus (DM) and DR among Pacific populations residing in the Counties Manukau District Health Board (CMDHB) region. The socio-demographic characteristics, health profile and diabetes management of this population will be examined. In addition, the completeness and accuracy of the routinely collected data reviewed will be assessed. Method: Secondary analyses using descriptive methods were undertaken on two routinely collected databases: the Virtual Diabetes Register (VDR) (a national diabetes monitoring tool) and the VIP.net (CMDHB diabetic retinal screening database). These datasets were linked to ascertain a complete profile of patients for the period January 2010 to December 2014. Findings: Pacific Peoples with diabetes (aged ≥ 15 years) in the CMDHB region had a DM prevalence of 16%. Cases identified were more likely to be female; of Samoan, Tongan or Cook Island Māori ethnicity and live in decile 9 or 10 areas. Two-thirds (65%) of Pacific Peoples with diabetes had retinopathy. Retinopathy was common among Pacific men, of Samoan, Tongan, Fijian or Fijian Indian ethnicities. More Pacific Peoples with diabetes were contained in the VDR than the VIP.net (88% of cases c.f. 72%). Conclusion: The burden of DM and DR among Pacific populations in NZ has been largely under-estimated. The current study indicates a need for greater prevention practices targeting this population, in particular an emphasis on retinal screening. The VDR could be strengthened by incorporating more data on diabetes complications such as retinopathy, and the use of more expanded ethnic categories for Pacific Peoples. Ensuring that the burden of diabetes is comprehensively portrayed in national information systems is necessary for effective service planning and monitoring the effectiveness of healthcare service delivery.