Diabetic retinopathy and the associated risk factors in diabetes type 2 patients in Abha, Saudi Arabia

Abstract

Objectives:To assess the proportion and grades of retinopathy and its risk factors in diabetes type 2 patients.Materials and Methods:This was a cross-sectional study of 401 type 2 diabetic patients. A questionnaire and checklist were used to collect the data. Retinopathy was diagnosed and graded by fundus photographs and slit lamp examination. The duration of diabetes, age of patients, age at onset of diabetes, body mass index, hemoglobin A1c level, blood pressure, and complications were noted.Results:The mean age of male and female patients was 54.93 and 54.25 years; 57.6% were males. The mean age of onset and mean duration of diabetes were 43.91 and 13.4 years, respectively. The proportion of retinopathy was 36.4%. Grades of retinopathy were: Mild 57.5%, moderate 19.9%, severe nonproliferative 11%, and proliferative retinopathy 11.6%; 7.2% of patients had maculopathy. Retinopathy was significantly associated with older age, younger age at onset, longer duration of disease, poorly controlled blood sugar, hypertension, insulin use; the presence of neuropathy and nephropathy appeared as a significant risk. Younger age at onset, longer duration, and insulin use appeared as the strongest predictors for diabetic retinopathy.Conclusions:More than a third (36.4%) of the diabetic patients attending a diabetic center had retinopathy. The control of the risk factors may reduce both prevalence and consequences of retinopathy.

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

“…There was a strong association between insulin therapy and DR in this study. Similar findings have been reported in studies from China, Finland, Jordan and Saudi Arabia [9,23,24,28,36]. Hypertension has a strong association with DR (P-value 0.0001), and this was well documented in most of the other studies [24,32,33,37,38].…”

“…Similar findings have been reported in studies from China, Finland, Jordan and Saudi Arabia [9,23,24,28,36]. Hypertension has a strong association with DR (P-value 0.0001), and this was well documented in most of the other studies [24,32,33,37,38]. Like other studies, smoking was not associated with DR (P-value 0.992) [5,9,11,24,39].…”

“…Hypertension has a strong association with DR (P-value 0.0001), and this was well documented in most of the other studies [24,32,33,37,38]. Like other studies, smoking was not associated with DR (P-value 0.992) [5,9,11,24,39]. The relationship between dyslipidemia and nephropathy has been proven in this study and other studies in Saudi Arabia and worldwide [8,21,[25][26][27][28]40].…”

“…Regarding association of obesity with diabetic retinopathy, this study found no significant association, since the relative risk (RR) of BMI (less than 30/more than 30) was 0.615 (95% CI 0.334-1.130). Although a positive correlation of obesity with DR has been found in some studies [3,9,24,[32][33][34], it was found to be protective in another studies [9)]. Controlling blood sugar is a protective factor [5,8,11,32,33,35], and this association was proven in this study.…”

“…National and international studies that have been conducted to determine the prevalence of diabetic retinopathy have reported values that range from 15% in some studies to 36% in others [19][20][21][22][23]. 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].…”