Within a shared geographic setting, Malayalam-speaking adults with T2DM had higher DR prevalence and severity than Tamil-speaking adults, after adjustment for age and diabetes duration, alongside differences in awareness and dietary fat patterns.
Key Findings
Results
Diabetic retinopathy was more prevalent among Malayalam-speaking than Tamil-speaking adults with type 2 diabetes in Gudalur taluk.
DR prevalence was 49.7% in Malayalam speakers versus 30.6% in Tamil speakers (P = 0.002).
The sample was 295 adults aged ≥40 years (Malayalam n = 171; Tamil n = 124).
Participants had a dilated fundus examination by indirect ophthalmoscopy at 12 outreach eye camps between January and December 2024.
The abstract also reports higher DR severity among Malayalam speakers.
Results
Malayalam mother tongue remained independently associated with any DR after adjustment.
Adjusted OR 1.88 (95% CI 1.10-3.22; P = 0.021).
Logistic regression was used to evaluate the association between mother tongue and any DR.
The abstract describes adjustment for age and diabetes duration.
Results
Malayalam speakers were older and had longer diabetes duration, while HbA1c was comparable between groups.
Older age among Malayalam speakers: P = 0.008.
Longer diabetes duration among Malayalam speakers: P < 0.001.
HbA1c was reported as comparable between the two groups.
Results
Malayalam speakers had higher diabetes awareness and annual eye examination uptake than Tamil speakers.
Awareness and annual eye examination uptake were higher among Malayalam speakers.
Knowledge and screening practices were assessed using standardized instruments.
Higher DR prevalence therefore occurred despite higher awareness and screening uptake.
Results
In the dietary subset, Malayalam speakers had higher total energy intake and a greater contribution of saturated fat.
Differences in total energy intake and saturated fat contribution were reported at P < 0.001.
Dietary intake was assessed in a subset of participants using standardized instruments.
Methods
The study design was a community-based cross-sectional screening of Tamil- and Malayalam-speaking adults with self-reported T2DM and long-term residence in Gudalur taluk.
Eligibility: age ≥40 years, self-reported T2DM, ≥10 years' residence in Gudalur taluk (Nilgiris, Tamil Nadu), and mother tongue Tamil or Malayalam.
Assessments covered sociodemographic and socioeconomic characteristics, anthropometry, diabetes duration, physical activity, knowledge and screening practices, and diet.
What This Means
This study looked at people with type 2 diabetes living in the same area, Gudalur in the Nilgiris of Tamil Nadu, to see whether diabetic eye disease (retinopathy) differed between those whose mother tongue is Tamil and those whose mother tongue is Malayalam. A total of 295 adults aged 40 or older were examined at outreach eye camps in 2024. About half of Malayalam speakers (49.7%) had diabetic retinopathy compared with about 3 in 10 Tamil speakers (30.6%).
Malayalam speakers were older and had had diabetes longer, but their average blood sugar control (HbA1c) was similar to that of Tamil speakers. Even after accounting for age and diabetes duration, Malayalam speakers had about 1.9 times the odds of having retinopathy. Malayalam speakers also reported greater awareness and more annual eye checks, yet had more eye disease. In a subset with dietary data, they had higher total energy intake and more saturated fat in their diets.
This research suggests that diabetic eye disease can differ between language or cultural groups even when they live in the same place, and that these differences are not fully explained by age, diabetes duration, or blood sugar levels. Because this was a single-time cross-sectional snapshot, it cannot show that language, diet, or any other factor causes the difference. The findings may help in planning screening and prevention programs for specific communities.
Jaju S, Chinnappan N, Sakthivel V, Nair A, Kumar M, Pandian J, et al.. (2026). Ethnolinguistic differences in diabetic retinopathy within a shared geographic setting in South India: The Gudalur diabetic retinopathy study.. Indian journal of ophthalmology. https://doi.org/10.4103/IJO.IJO_61_26