John Landers1, Tim Henderson2, Jamie Craig1

Purpose: To demonstrate the associations between 10 year mortality and the presence of diabetic retinopathy (DR) among indigenous Australians living within central Australia.

Methods: 1,257 individuals aged 40 years or older, living in one of 30 remote communities within the statistical local area of ‘Central Australia’ were recruited for this study. Following dilated slit-lamp fundoscopy, the amount of DR in participants with diabetes mellitus (DM) was quantified using the Early Treatment of Diabetic Retinopathy Study criteria. Patients were then followed in these remote clinics over the subsequent 10 years. 10 year all-cause mortality rates and their associations with the presence of DR were presented.

Results: At the end of 10 years, confirmed all-cause mortality was found to be 29.3%. The presence of DR was associated with this. Of those with DM but no DR, 24.0% died during the 10 years after recruitment. This increased significantly for those with DM and any DR (40.1%)(P<0.0001). After adjustment for age, sex and hypertension, those who with any DR were 54% more likely to die during the 10 years of follow-up (HR 1.54; P<0.0001).

Conclusion: This is the first study which has shown the 10 year all-cause mortality of indigenous Australians and its associations with the presence of DR. The presence of any DR among those with DM, was associated with a 54% greater 10 year all-cause mortality rate. This highlights the severity of this condition and emphasizes the need for more resources to target risk factor control amongst this cohort.