Diabetic retinopathy and its risk factors in a society with a type 2 diabetes epidemic: a Saudi National Diabetes Registry‐based study

Abstract

ABSTRACT.Purpose: To assess diabetic retinopathy prevalence and its risk factors in a society with type 2 diabetes epidemic using the Saudi National Diabetes Registry (SNDR). Method: This is a cross-sectional study using patient's clinical data found in SNDR data base. A cohort of 50 464 Saudi patients with type 2 diabetes aged ≥25 years were selected to assess for the prevalence and risk factors for diabetic retinopathy. Results: The overall prevalence of diabetic retinopathy is 19.7%, where 9.1% have non-proliferative diabetic retinopathy (NPDR), 10.6% have proliferative diabetic retinopathy (PDR) and 5.7% have macular oedema (ME). Duration of diabetes and age are the most significant risk factors for diabetic retinopathy with odds ratio (OR) and 95% confidence interval (95% CI) 8.88 (8.30-9.50) and 5.76 (5.10-6.55), respectively. Nephropathy, neuropathy, insulin use, poor glycemic control, hypertension and male gender significantly increased the risk for diabetic retinopathy. Smoking, hyperlipidemia and obesity significantly reduced the risk for diabetic retinopathy among type 2 Saudi diabetic cohort. Conclusion: vThe low prevalence of diabetic retinopathy in our registry may be a result of the shortage or absence of well-structured screening programmes. Therefore, many patients with NPDR might have been missed. A prevention programme is needed to reduce the effect of diabetic retinopathy risk factors in this society.

The Impact of Expanding the Screening Interval for Diabetic Retinopathy in Primary Care Centers

“…Studies from Saudi Arabia's southern region reported a prevalence of 36.4%, which is much higher than the previously reported prevalence of Health Prim Car, 2018 doi: 10.15761/HPC.1000134 11.3% in the same region by Al-Khaldi, et al [24]. The last study using the Saudi National Diabetes Registry (SNDR) found that the overall prevalence of diabetic retinopathy of only 19.7% [9]. In most of these studies, the risk factors were related to age, the duration of diabetes mellitus and poor glycemic control, while other factors, such as gender, obesity, smoking, nephropathy, and neuropathy, had no clear associations with diabetic retinopathy [9,[25][26][27][28][29].…”

“…The overall global prevalence of DR among patients with type 2 diabetes is 27.23%, while the prevalence of DR among different ethnic groups varies widely from 20.8% among Asians to 46.7% among Caucasians [8]. Moreover, the data collected from the Saudi National Diabetes Registry indicates that the overall prevalence of diabetic retinopathy is 19.7% (9). The risk factors are mainly related to age, the duration of diabetes and glycemic control; other factors, such as obesity, dyslipidemia and nephropathy, were variably associated [9,10].…”

“…Moreover, the data collected from the Saudi National Diabetes Registry indicates that the overall prevalence of diabetic retinopathy is 19.7% (9). The risk factors are mainly related to age, the duration of diabetes and glycemic control; other factors, such as obesity, dyslipidemia and nephropathy, were variably associated [9,10]. In Saudi Arabia, nephropathy, neuropathy, insulin use, poor glycemic control, hypertension and male gender significantly increased the risk for diabetic retinopathy, while smoking, hyperlipidemia and obesity significantly were associated with reduced risk for diabetic retinopathy among Saudi type 2 diabetics [9].…”

“…The risk factors are mainly related to age, the duration of diabetes and glycemic control; other factors, such as obesity, dyslipidemia and nephropathy, were variably associated [9,10]. In Saudi Arabia, nephropathy, neuropathy, insulin use, poor glycemic control, hypertension and male gender significantly increased the risk for diabetic retinopathy, while smoking, hyperlipidemia and obesity significantly were associated with reduced risk for diabetic retinopathy among Saudi type 2 diabetics [9]. Regular screening is the best method for the early detection of diabetic retinopathy and is strongly recommended since early detection has the best chance of preventing retinal complications and blindness [5,7,11,12].…”

A Study Protocol to Assess the Determinants of Glycaemic Control, Complications and Health Related Quality of Life for People with Type 2 Diabetes in Saudi Arabia

“…However, some of the studies from Saudi Arabia used random blood sugar for determining the level of control, which was a limitation to these studies. In addition, the majority of studies from Saudi Arabia involved a single centre, or were hospital-based [8][9][10]13,[18][19][20][21][22][23][24][25][26] and may not accurately represent the large and diverse population of the country.…”