Burden of Diabetic Retinopathy amongst People with Diabetes Attending Primary Care in Kerala: Nayanamritham Project

Abstract

Background: The burden of diabetic retinopathy (DR) in people attending the public health sector in India is unclear. Thirty percent of the population in India is reliant on public healthcare. This study aimed to estimate the prevalence of DR and its risk factors in people with diabetes in the non-communicable disease registers who were attending the family health centres (FHCs) in the Thiruvananthapuram district in Kerala. Methods: This cross-sectional study was conducted over 12 months in 2019 within the framework of a pilot district-wide teleophthalmology DR screening programme. The age- and gender-adjusted prevalence of any DR and sight-threatening DR (STDR) in the whole sample, considering socio-demography, lifestyle and known clinical risk groups, are reported. Results: A total of 4527 out of 5307 (85.3%) screened in the FHCs had gradable retinal images in at least one eye. The age and gender standardised prevalence for any DR was 17.4% (95% CI 15.1, 19.7), and STDR was 3.3% (95% CI 2.1, 4.5). Ages 41–70 years, males, longer diabetes duration, hyperglycaemia and hypertension, insulin users and lower socio-economic status were associated with both DR outcomes. Conclusions: The burden of DR and its risk factors in this study highlights the need to implement DR screening programs within primary care to reduce health inequality.

Early detection of peripheral neuropathy and its correlation with retinopathy and HbA1c levels in type 2 diabetes mellitus patients

“…The prevalence of diabetic retinopathy in our study was 18.1% (95% CI: 11.9-26.5) similar to the prevalence of DR reported by Sivaprasad S et al 16 which had 17.4% (95% CI 15.1%, 19.7%). In another study by Zegeye AF et al, 17 the prevalence was high at 36.3% (95% CI:29.8-47.6).…”

Estimating the costs of blindness and moderate to severe visual impairment among people with diabetes in India

“…This cost of illness study is part of the ORNATE India research project,7 which aims to evaluate cost-effective measures for screening for diabetes and its complications and to examine the potential impact of a reduction in the prevalence of blindness on the Indian economy. The project includes an evaluation of a pilot screening programme for DR in Kerala, the Nayanamritham Project,8 9 and an evaluation of a community screening programme for diabetes and its complications in 20 areas of India covering all the six regions, the SMART India Project 10…”