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Incidence of Cataract Extraction in Pima Indians: Diabetes as a Risk Factor

Incidence of Cataract Extraction in Pima Indians: Diabetes as a Risk Factor Abstract • The incidence of visually disabling cataract was estimated by the rate of first cataract extraction in a population of Pima Indians in Arizona. The annual age-specific rates of cataract surgery (first and second eyes) were 3.7 to 5.9 times as high as the estimated US rates. Diabetes was a strong risk factor for first cataract surgery in all age and sex groups except in men aged 75 to 84 years. Overall, with age and sex controlled, the rate of first cataract surgery was 2.2 times as high (95% confidence interval, 1.3 to 3.9) in diabetic as in nondiabetic subjects. Cataract surgery was related to the duration and type of treatment of diabetes. Insulin-treated diabetics had about five times the rate of those with normal glucose tolerance. The rate of cataract surgery was lowest in subjects with normal glucose tolerance, somewhat higher in those with impaired glucose tolerance, and even higher with increasing duration of diabetes. References 1. Duke-Elder S (ed): System of Ophthalmology . London, Henry Kimpton Publishers, 1969, vol 11: Diseases of the Lens and Vitreous: Glaucoma and Hypotony , chap 3. 2. Dawson CR, Schwab IR: Epidemiology of cataract: A major cause of preventable blindness . Bull WHO 1981;59:493-501. 3. National Health and Nutrition Examination Survey: Ophthalmology Examination Protocol. Hyattsville, Md, US Department of Health, Education and Welfare, National Center for Health Statistics, 1972. 4. Ederer F, Hiller R, Taylor HR: Senile lens changes and diabetes: Two population studies . Am J Ophthalmol 1981;91:381-395. 5. Kahn HA, Leibowitz HM, Ganley JP, et al: The Framingham Study: I. Outline and major prevalence findings . Am J Epidemiol 1977;106:17-32. 6. Kahn HA, Leibowitz HM, Ganley JP, et al: The Framingham Eye Study: II. Association of ophthalmic pathology with single variables previously measured in the Framingham Heart Study . Am J Epidemiol 1977;106:33-41. 7. Leibowitz HM, Krueger DE, Maunder LR, et al: The Framingham Eye Study monograph . Surv Ophthalmol 1980;24( (suppl) ):335-610.Crossref 8. Hiller R, Kahn HA: Senile cataract extraction and diabetes . Br J Ophthalmol 1976;60:283-286.Crossref 9. Caird FI, Hutchinson M, Pirie A: Cataract and diabetes . Br Med J 1964;2:665-667.Crossref 10. Sommer A: Cataracts as an epidemiologic problem . Am J Ophthalmol 1971;83:334-339. 11. Knowler WC, Bennett PH, Hamman RF, et al: Diabetes incidence and prevalence in Pima Indians: A 19-fold greater incidence than in Rochester, Minnesota . Am J Epidemiol 1978; 108:497-505. 12. Bennett PH, Burch TA, Miller M: Diabetes mellitus in American (Pima) Indians . Lancet 1971;2:125-128.Crossref 13. WHO Expert Committee on Diabetes Mellitus: Second report. WHO Tech Rep Ser 646, 1980, pp 8-12. 14. Nadler DJ, Schwartz B: Cataract surgery in the United States, 1968-1976: A descriptive epidemiologic study . Ophthalmology 1980;87:10-18.Crossref 15. Utilization of short stay hospitals: Annual summary for the United States, 1978, in National Health Survey Series 13, No. 46. Hyattsville, Md, US Dept of Health, Education, and Welfare publication (PHS) 80-1797, National Center for Health Statistics. 16. Estimates of the population of the United States, by age, sex, and race, July 1,1974 to 1976, in Current Population Reports. Washington, DC, US Bureau of the Census, series No. 643, 1977, p 25. 17. Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease . J Natl Cane Inst 1959;22:719-748. 18. Rothman KJ, Boice JE Jr: Epidemiologic Analysis With a Programmable Calculator . National Institutes of Health (NIH) publication 79-1649. Washington, DC, NIH, 1979. 19. Mantel N: Chi-square tests with one degree of freedom: Extension of the Mantel-Haenszel procedure : J Am Stat Assoc 1963;59:690-700. 20. Jarrett RJ, Keen H: Hyperglycemia and diabetes mellitus . Lancet 1976;2:1009-1012.Crossref 21. Al Sayegh H, Jarrett RJ: Oral glucose tolerance tests and the diagnosis of diabetes: Results of a prospective study based on the Whitehall Survey . Lancet 1979;2:431-433.Crossref 22. Pettitt DJ, Knowler WC, Lisse JR, et al: Development of retinopathy and proteinuria in relation to plasma-glucose concentrations in Pima Indians . Lancet 1980;2:1050-1052.Crossref 23. Knowler WC, Bennett PH, Ballintine EJ: Increased incidence of retinopathy in diabetics with elevated blood pressure: A six-year follow-up study in Pima Indians . N Engl J Med 1980; 302:645-650.Crossref 24. Hollows F, Moran D: Cataract: The ultraviolet risk factor . Lancet 1981;5:1249-1250.Crossref 25. Dhir SP, Detels R, Alexander ER: The role of environmental factors in cataract, pterygium and trachoma . Am J Ophthalmol 1967;64:128-135. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Incidence of Cataract Extraction in Pima Indians: Diabetes as a Risk Factor

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Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1985.01050020060020
Publisher site
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Abstract

Abstract • The incidence of visually disabling cataract was estimated by the rate of first cataract extraction in a population of Pima Indians in Arizona. The annual age-specific rates of cataract surgery (first and second eyes) were 3.7 to 5.9 times as high as the estimated US rates. Diabetes was a strong risk factor for first cataract surgery in all age and sex groups except in men aged 75 to 84 years. Overall, with age and sex controlled, the rate of first cataract surgery was 2.2 times as high (95% confidence interval, 1.3 to 3.9) in diabetic as in nondiabetic subjects. Cataract surgery was related to the duration and type of treatment of diabetes. Insulin-treated diabetics had about five times the rate of those with normal glucose tolerance. The rate of cataract surgery was lowest in subjects with normal glucose tolerance, somewhat higher in those with impaired glucose tolerance, and even higher with increasing duration of diabetes. References 1. Duke-Elder S (ed): System of Ophthalmology . London, Henry Kimpton Publishers, 1969, vol 11: Diseases of the Lens and Vitreous: Glaucoma and Hypotony , chap 3. 2. Dawson CR, Schwab IR: Epidemiology of cataract: A major cause of preventable blindness . Bull WHO 1981;59:493-501. 3. National Health and Nutrition Examination Survey: Ophthalmology Examination Protocol. Hyattsville, Md, US Department of Health, Education and Welfare, National Center for Health Statistics, 1972. 4. Ederer F, Hiller R, Taylor HR: Senile lens changes and diabetes: Two population studies . Am J Ophthalmol 1981;91:381-395. 5. Kahn HA, Leibowitz HM, Ganley JP, et al: The Framingham Study: I. Outline and major prevalence findings . Am J Epidemiol 1977;106:17-32. 6. Kahn HA, Leibowitz HM, Ganley JP, et al: The Framingham Eye Study: II. Association of ophthalmic pathology with single variables previously measured in the Framingham Heart Study . Am J Epidemiol 1977;106:33-41. 7. Leibowitz HM, Krueger DE, Maunder LR, et al: The Framingham Eye Study monograph . Surv Ophthalmol 1980;24( (suppl) ):335-610.Crossref 8. Hiller R, Kahn HA: Senile cataract extraction and diabetes . Br J Ophthalmol 1976;60:283-286.Crossref 9. Caird FI, Hutchinson M, Pirie A: Cataract and diabetes . Br Med J 1964;2:665-667.Crossref 10. Sommer A: Cataracts as an epidemiologic problem . Am J Ophthalmol 1971;83:334-339. 11. Knowler WC, Bennett PH, Hamman RF, et al: Diabetes incidence and prevalence in Pima Indians: A 19-fold greater incidence than in Rochester, Minnesota . Am J Epidemiol 1978; 108:497-505. 12. Bennett PH, Burch TA, Miller M: Diabetes mellitus in American (Pima) Indians . Lancet 1971;2:125-128.Crossref 13. WHO Expert Committee on Diabetes Mellitus: Second report. WHO Tech Rep Ser 646, 1980, pp 8-12. 14. Nadler DJ, Schwartz B: Cataract surgery in the United States, 1968-1976: A descriptive epidemiologic study . Ophthalmology 1980;87:10-18.Crossref 15. Utilization of short stay hospitals: Annual summary for the United States, 1978, in National Health Survey Series 13, No. 46. Hyattsville, Md, US Dept of Health, Education, and Welfare publication (PHS) 80-1797, National Center for Health Statistics. 16. Estimates of the population of the United States, by age, sex, and race, July 1,1974 to 1976, in Current Population Reports. Washington, DC, US Bureau of the Census, series No. 643, 1977, p 25. 17. Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease . J Natl Cane Inst 1959;22:719-748. 18. Rothman KJ, Boice JE Jr: Epidemiologic Analysis With a Programmable Calculator . National Institutes of Health (NIH) publication 79-1649. Washington, DC, NIH, 1979. 19. Mantel N: Chi-square tests with one degree of freedom: Extension of the Mantel-Haenszel procedure : J Am Stat Assoc 1963;59:690-700. 20. Jarrett RJ, Keen H: Hyperglycemia and diabetes mellitus . Lancet 1976;2:1009-1012.Crossref 21. Al Sayegh H, Jarrett RJ: Oral glucose tolerance tests and the diagnosis of diabetes: Results of a prospective study based on the Whitehall Survey . Lancet 1979;2:431-433.Crossref 22. Pettitt DJ, Knowler WC, Lisse JR, et al: Development of retinopathy and proteinuria in relation to plasma-glucose concentrations in Pima Indians . Lancet 1980;2:1050-1052.Crossref 23. Knowler WC, Bennett PH, Ballintine EJ: Increased incidence of retinopathy in diabetics with elevated blood pressure: A six-year follow-up study in Pima Indians . N Engl J Med 1980; 302:645-650.Crossref 24. Hollows F, Moran D: Cataract: The ultraviolet risk factor . Lancet 1981;5:1249-1250.Crossref 25. Dhir SP, Detels R, Alexander ER: The role of environmental factors in cataract, pterygium and trachoma . Am J Ophthalmol 1967;64:128-135.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Feb 1, 1985

References