Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients Attending the Diabetic Clinic of the University of Gondar Hospital, Northwest Ethiopia

Abstract

Objective. To investigate the level of diabetic retinopathy in type 2 diabetes (T2DM) patients attending the University of Gondar Hospital (UGH) Diabetic Clinic, Northwest Ethiopia. Methods. An audit was carried out involving a total of 739 T2DM patients attending at the diabetic clinic of UGH. They represented approximately 90% and 50% of all T2DM patients under regular review at the urban and rural diabetic clinics of UGH, respectively. All were supervised by the same clinical team for a long period. Eye examinations were performed for visual acuity, cataract, and retinal changes (retinal photography and slit-lamp biomicroscopy). Body mass index (BMI) and HbA1c levels were measured. The presence or absence of hypertension was recorded. Results. Men constituted 41.5% of the group, the mean age at diagnosis of T2DM was 50.4 years, and 50.2% were hypertensive. The BMI was 25.0 ± 4.1 kg/m2, and HbA1c was 7.75 ± 1.63% (61.2 ± 17.8 mmol/mol) (mean ± SD, for BMI and HbA1c)). Severe visual impairment/blindness was reported in 10.6%, 15.2% had cataract, 16.0% had retinopathy, and 11.1% had maculopathy. The prevalence of retinopathy increased with time from diagnosis of T2DM (chi-square for trend, p < 0.001 ) and with increasing HbA1c level (chi-square for trend, p = 0.03 ). Conclusion. These results compare well with the most recent results in well-equipped, wealthier regions of the world and show the importance of stable healthcare infrastructure for chronic-disease management.

Prevalence of diabetic macular edema and risk factors among diabetic patients at the University of Gondar Tertiary Eye Care and Training Center, North West Ethiopia

“…A majority of participants in this study,79.4%, were type-II DM patients and this is similar with previous studies done in Ethiopia, 88.4% in Gondar, 72.8% in Jimma and 60.92% Debre marcos (10,11,28,29)…”

“…However, the reported prevalence of DME in previous studies in this region of NW Ethiopia, 11%, 6.4% and 5.7%, is lower than our report and this may be because of the differences in the study setting, method of data collection and sample size. (10,11,29) Similar diabetic clinic based studies in Cameroon 8% and in South Africa 12.5%, also reported a lower prevalence of DME than ours. (6,7)…”

“…A majority of participants in this study,79.4%, were type-II DM patients and this is similar with previous studies done in Ethiopia, 88.4% in Gondar, 72.8% in Jimma and 60.92% Debre marcos (10,11,28,29) Longer duration of DM was strongly associated with diabetic macular edema in many studies. (2,3,10,11) However our study did not find association between duration of diabetes with development of DME and this may be because nearly half of our study patients, 44.8%, had duration of diabetes less than five years.…”

“…The prevalence of diabetic retinopathy in this study 33.3% is higher than diabetic clinic based previous reports from this region 16 % (10) and 18.9 % (29) however a study done in Jimma South West Ethiopia and another study done in NW Ethiopia reported higher figures than this study, 42.2% and 41.4% respectively. (11,28) This may be due to the differences in data collection technique, sample size and study setting.…”

“…In Ethiopia, the prevalence ranges from 5.7% to 11%. (10,11) Different factors have been found to be associated with DME including type-I diabetes (12,13,14) poor glycemic control (15,16,17,18), longer duration of DM (1,3,12,16), systemic hypertension (3,8,13,16,17,18,19) , dyslipidemia (12,20), insulin therapy (3,6), proteinuria (3,15,20) and cataract surgery (15,17,21).…”