Objective To identify factors associated with sight-threatening diabetic macular oedema (STDM) in Indigenous Australians attending an Indigenous primary care clinic in remote Australia. Methods and analysis A cross-sectional study design of retinopathy screening data and routinely-collected clinical data among 236 adult Indigenous participants with type 2 diabetes (35.6% men) set in one Indigenous primary care clinic in remote Australia. The primary outcome variable was STDM assessed from retinal images. Results Age (median (range)) was 48 (21–86) years, and known diabetes duration (median (range)) was 8.0 (0–24) years. Prevalence of STDM was high (14.8%) and similar in men and women. STDM was associated with longer diabetes duration (11.7 vs 7.9 years, respectively; p<0.001) and markers of renal impairment: abnormal estimated Glomerular Filtration Rate (eGFR) (62.9 vs 38.3%, respectively; p=0.007), severe macroalbuminuria (>300 mg/mmol) (20.6 vs 5.7%, respectively; p=0.014) and chronic kidney disease (25.7 vs 12.2%, respectively; p=0.035). Some clinical factors differed by sex: anaemia was more prevalent in women. A higher proportion of men were smokers, prescribed statins and had increased albuminuria. Men had higher blood pressure, but lower glycated Haemoglobin A1c (HbA1c) levels and body mass index, than women. Conclusion STDM prevalence was high and similar in men and women. Markers of renal impairment and longer diabetes duration were associated with STDM in this Indigenous primary care population. Embedded teleretinal screening, known diabetes duration-based risk stratification and targeted interventions may lower the prevalence of STDM in remote Indigenous primary care services. Trial registration number Australia and New Zealand Clinical Trials Register: ACTRN 12616000370404. Data may be obtained from a third party and are not publicly available.

中文翻译：

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在澳大利亚偏远地区的土著初级保健诊所就诊的 2 型糖尿病土著成年人与威胁视力的糖尿病性黄斑水肿的关联：糖尿病视网膜病变和远程医疗眼及相关医疗服务网络研究卓越研究中心

目的 确定与澳大利亚偏远地区土著初级保健诊所就诊的澳大利亚土著人中威胁视力的糖尿病性黄斑水肿 (STDM) 相关的因素。方法和分析 在澳大利亚偏远地区的一个土著初级保健诊所中，对 236 名患有 2 型糖尿病的成年土著参与者（35.6% 男性）进行了视网膜病变筛查数据和常规收集的临床数据的横断面研究设计。主要结果变量是从视网膜图像评估的 STDM。结果 年龄（中位数（范围））为 48（21-86）岁，已知糖尿病病程（中位数（范围））为 8.0（0-24）年。STDM 的患病率很高（14.8%），男性和女性相似。STDM 与较长的糖尿病病程（分别为 11.7 和 7.9 年；p<0.001）和肾损害标志物相关：估计肾小球滤过率 (eGFR) 异常（分别为 62.9 对 38.3%；p=0.007）、严重大量白蛋白尿（>300 mg/mmol）（分别为 20.6 对 5.7%；p=0.014）和慢性肾病（25.7 对 12.2） %，分别为；p = 0.035)。一些临床因素因性别而异：贫血在女性中更为普遍。较高比例的男性是吸烟者，服用他汀类药物并且白蛋白尿增加。与女性相比，男性的血压较高，但糖化血红蛋白 A1c (HbA1c) 水平和体重指数较低。结论 STDM 患病率在男性和女性中均较高且相似。在这个土著初级保健人群中，肾功能损害的标志物和较长的糖尿病病程与 STDM 相关。嵌入式远程视网膜筛查，已知的基于糖尿病持续时间的风险分层和有针对性的干预措施可能会降低偏远土著初级保健服务中 STDM 的患病率。试验注册号澳大利亚和新西兰临床试验注册：ACTRN 12616000370404。数据可能从第三方获得，不公开。