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Frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes presenting at a tertiary care hospital

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objective

To evaluate frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes.

Methodology

This prospective observational study was conducted from January 2017 to June 2017 at the outpatient department of Baqai Institute of Diabetology and Endocrinology (BIDE) and Baqai Medical University a tertiary care diabetes hospital of Karachi, Pakistan. Convenience sampling was done. Demographic, anthropometric, clinical, and biochemical data were collected, and ophthalmic screening was performed by funduscopy at a slit lamp biomicroscopy with the help 90 D fundus lens. Grading of diabetic retinopathy was done according to the modified Early Treatment Diabetic Retinopathy Disease Severity Scale (ETDRS) criteria.

Result

Retinopathy was present in 17.5% of patients. Non-sight-threatening retinopathy was found in 15.2% and sight-threatening retinopathy was found in 17.6%. In table 4, logistic regression analysis determined the relationship between retinopathy and its possible risk factors. In univariate logistic regression model, Age, poor glycemic control and longer duration of diabetes were found to be significant risk factors for developing retinopathy. In multivariate logistic regression model, duration of diabetes remained significantly associated with the development of retinopathy. Additionally, gender was not significantly associated in univariate analysis but it became significant after adjustment in multivariate model.

Conclusion

An early screening program reduces the risk of incidence of diabetic retinopathy. Hence, screening of retinopathy should be done once in a year.

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References

  1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011;94(3):311–21. https://doi.org/10.1016/j.diabres.2011.10.029.

    Article  PubMed  Google Scholar 

  2. Basit A, Fawwad A, Qureshi H, Shera AS. Prevalence of diabetes, pre-diabetes and associated risk factors: second National Diabetes Survey of Pakistan (NDSP), 2016–2017. BMJ Open. 2018;8(8):020961. https://doi.org/10.1136/bmjopen-2017-020961.

    Article  Google Scholar 

  3. Chisha Y, Terefe W, Assefa H, Lakew S. Prevalence and factors associated with diabetic retinopathy among diabetic patients at Arbaminch General Hospital, Ethiopia: Cross sectional study. PLoS One. 2017;12(3):e0171987. https://doi.org/10.1371/journal.pone.0171987.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Available at : Idf atlas 2017. Accessed by 14.5.2018.

  5. Mumtaz SN, Fahim MF, Arslan M, Shaikh SA, Kazi U, Memon MS. Prevalence of diabetic retinopathy in Pakistan: A systematic review. Pak J Med Sci. 2018;34(2):493–500. https://doi.org/10.12669/pjms.342.13819.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Rodriguez-Poncelas A, Miravet-Jiménez S, Casellas A, Barrot-De La Puente JF, Franch-Nadal J, López Simarro F, et al. Prevalence of diabetic retinopathy in individuals with type 2 diabetes who had recorded diabetic retinopathy from retinal photographs in Catalonia (Spain). Br J Ophthalmol. 2015;99(12):1628–33. https://doi.org/10.1136/bjophthalmol-2015-306683.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Gerstein HC, Ambrosius WT, Danis R, Ismail-Beigi F, Cushman W, Calles J, et al. ACCORD Study Group.Diabetic retinopathy, its progression, and incident cardiovascular events in the ACCORD trial. Diabetes Care. 2013;36(5):1266–71. https://doi.org/10.2337/dc12-1311.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4–14. https://doi.org/10.1016/j.diabres.2009.10.007.

  9. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.

    Article  Google Scholar 

  10. Matthews DR, Stratton IM, Aldington SJ, Holman RR, Kohner EM, UK Prospective Diabetes Study Group. Risks of progression of retinopathy and vision loss related to tight blood pressure control in in type 2 diabetes mellitus UKPDS 69. UK Prospectivions. Arch Ophthalmol. 2004;122(11):16311640. https://doi.org/10.1001/archopht.122.11.1631.

    Article  Google Scholar 

  11. Hydrie ZI, Basit A. Prevelence of retinopathy. Baqai Journal of Health Sciences (BJHS). 2002;5:6–19.

  12. Liu Y, Song Y, Tao L, Qiu W, Lv H, Jiang X, et al. Prevalence of diabetic retinopathy among 13473 patients with diabetes mellitus in China: a cross-sectional epidemiological survey in six provinces. BMJ Open. 2017;7(1):e013199. https://doi.org/10.1136/bmjopen-2016-013199.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Looker HC, Nyangoma SO, Cromie D, Olson JA, Leese GP, Black M, et al. Diabetic retinopathy at diagnosis of type 2 diabetes in Scotland. Diabetologia. 2012;55(9):2335–42.

    Article  CAS  Google Scholar 

  14. Thomas RL, Dunstan FD, Luzio SD, Chowdhury SR, North RV, Hale SL, et al. Prevalence of diabetic retinopathy within a national diabetic retinopathy screening service. Br J Ophthalmol. 2015;99(1):64–8. https://doi.org/10.1136/bjophthalmol-2013-304017.

    Article  PubMed  Google Scholar 

  15. Praveen V, Sameeksha S, 1 Noopur G, and Rohit S. Role of Early Screening for Diabetic Retinopathy in Patients with Diabetes Mellitus: An OverviewJ Community Med. 2011; 36(4): 247-252.DOI: https://doi.org/10.4103/0970-0218.91324.

  16. Elwali ES, Almobarak AO, Hassan MA, Mahmooud AA, Awadalla H, Ahmed MH. Frequency of diabetic retinopathy and associated risk factors in Khartoum, Sudan: population based study. International journal of ophthalmology. 2017;10(6):948. https://doi.org/10.18240/ijo.2017.06.18

  17. Hydrie ZI. Shahid Ahsan, Abdul Basit, KaziRumana Ahmed, Liaquat Ali, Rabeya Khanam, Asher Fawwad & Muhammad.Risk indicators of diabetic retinopathy in patients with type 2 diabetes screened by fundus photographs: a study from Pakistan .Int J Diabetes Dev Ctries 2015. https://doi.org/10.1007/s13410-014-0277-9.

  18. Prasad. J R, Nayana. G. Association of Diabetic Retinopathy in Type II Diabetes Mellitus with Hba1c Levels: A Study . IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) .2016;15(7): 48-53. https://doi.org/10.9790/08531507114853.

  19. Alvi R, Memon MS, Shera S, Mumtaz SN, Shaikh SA, Fahim MF. Visual outcome of laser treatment in diabetic macular edema: Study from an Urban Diabetes Care Center. Pakistan journal of medical sciences. 2016;32(5):1229. https://doi.org/10.12669/pjms.325.10597.

  20. Ahmed RA, Khalil SN, Al-Qahtani MA. Diabetic retinopathy and the associated risk factors in diabetes type 2 patients in Abha, Saudi Arabia.Journal of family & community medicine. 2016 Jan;23(1):18. https://doi.org/10.4103/22308229.172225.

  21. El Haddad OA, Saad MK. Prevalence and risk factors for diabetic retinopathy among Omani diabetics. British journal of ophthalmology.1998;82(8):901-6. https://doi.org/10.1136/bjo.82.8.901.

  22. Ting DS, Cheung GC, Wong TY. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review.Clinical & experimental ophthalmology. 2016 ;44(4):260-77.

  23. Mowatt L. Diabetic retinopathy and its risk factors at the university hospital in Jamaica. Middle East Afr J Ophthalmol. 2013;20(4):321–326.

  24. Younis N, Broadbent DM, Harding SP, Vora JP. Prevalence of diabetic eye disease in patients entering a systematic primary care based eye screening programme.Diabetic Medicine. 2002 ;19(12):101421. https://doi.org/10.1046/j.1464-5491.2002.00854.x.

  25. Shrestha MK, Paudyal G, Wagle RR, Gurung R, Ruit S, Onta SR. Prevalence of and factors associated with diabetic retinopathy among diabetics in Nepal: a hospital based study. Nepal Med Coll J. 2007 Dec;9(4):225-9

  26. Raman R, Rani PK, Kulothungan V, Rachepalle SR, Kumaramanickavel G, Sharma T. Influence of Serum Lipids on Clinically Significant versus Nonclinically Significant Macular Edema: SN-DREAMS Report Number 13⁎. Ophthalmology.2010; 117(4):766- 72. https://doi.org/10.1016/j.ophtha.2009.09.005.

  27. Benarous R, Sasongko MB, Qureshi S, Fenwick E, Dirani M, Wong TY, Lamoureux EL. Differential association of serum lipids with diabetic retinopathy and diabetic macular edema. Investigative ophthalmology & visual science.2011 ;52(10):7464-9. https://doi.org/10.1167/iovs.11-7598.

  28. Thapa R, Deepak MJ, AparnaRizyal (2014).Diabetic retinopathy at a tertiary level hospital.Nepal J Ophthalmol; (11):24- 30. https://doi.org/10.3126/nepjoph.v6i1.10760.

  29. Alvi R, Memon MS, Shera S, Mumtaz SN, Shaikh SA, Fahim MF. Visual outcome of laser treatment in diabetic macular edema: Study from an Urban Diabetes Care Center. Pakistan journal of medical sciences. 2016;32(5):1229. https://doi.org/10.12669/pjms.325.10597.

  30. Jew OM, Peyman M, Chen TC, Visvaraja S. Risk factors for clinically significant macular edema in a multi- ethnics population with type 2 diabetes. International journal of ophthalmology. 2012;5(4):499. https://doi.org/10.3980/j.issn.2222-3959.2012.04.18.

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Authors and Affiliations

  1. Unit 2 Eye Department, Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan

    Sharjeel Sultan, Nisar Ahmed Siyal & Abdul Rasheed Khokar

  2. Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan

    Sharjeel Sultan & Abdul Basit

  3. Department of Biochemistry, Baqai Medical University, Karachi, Pakistan

    Asher Fawwad

  4. Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan

    Asher Fawwad & Anum Butt

Authors
  1. Sharjeel Sultan
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  2. Asher Fawwad
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  3. Nisar Ahmed Siyal
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  4. Anum Butt
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  5. Abdul Rasheed Khokar
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  6. Abdul Basit
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Contributions

SS: Concept and design, researched data, wrote and reviewed the manuscript

AF: Concept and design, edited and reviewed the manuscript

ARK: Researched data, edited and reviewed the manuscript

AB: Wrote and reviewed the manuscript

NAS: Edited and reviewed the manuscript

AB: Concept and design, edited and reviewed the manuscript

Corresponding author

Correspondence to Asher Fawwad.

Ethics declarations

Ethical approval for the study was obtained from the institutional review board (IRB) of BIDE.

Conflict of interest

The authors declare that they have no conflict of interest.

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Sultan, S., Fawwad, A., Siyal, N.A. et al. Frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes presenting at a tertiary care hospital. Int J Diabetes Dev Ctries 40, 87–92 (2020). https://doi.org/10.1007/s13410-019-00756-9

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  • DOI: https://doi.org/10.1007/s13410-019-00756-9

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