The association between diabetes and cataract among 42,469 community-dwelling adults in six low- and middle-income countries

Background: Cataract is a major cause of visual impairment in people with diabetes, yet a paucity of data is available in low- and middle-income countries (LMICs) on this comorbidity. Thus we assessed the association between diabetes and cataract in 6 LMICs. Methods: Cross-sectional, community-based data from the Study on Global Ageing and Adult Health (SAGE) was analyzed (n = 42,469 aged >=18 years). Five years information on self-reported diagnosis of cataract was collected. Three definitions for cataract were used: (a) Self-reported diagnosis and/or past 12-month symptoms; (b) Solely self-reported diagnosis; and (c) Surgical treatment for cataract in the past five years. Diabetes was based on self-reported diagnosis. Multivariable logistic regression was conducted to assess the associations. Results: Overall, the prevalence of diabetes was 3.1% (95%CI = 2.7-3.5%) and that of cataract based on the three different definitions was: (a) 13.3% (95%CI = 12.4-14.3%); (b) 4.4% (95%CI = 3.9-4.8%), (c) 1.7% (95%CI = 1.5-2.0%). After adjustment the association was significantly elevated: (a) OR = 2.10 (95%CI = 1.59-2.76); (b) OR = 2.62 (95%CI = 2.00-3.42); (c) OR = 2.80 (95%CI = 1.78-4.40). These associations were particularly pronounced among those aged <50 years. Conclusions: A strong association between diabetes and cataract was observed in LMICs. Considering the impact on health and quality of life and the limited treatment options especially for cataract it is mandatory to promote the prevention through bi-directional screening and treatment.