Prevalence and risk factors for diabetes and diabetic retinopathy: results from the Nigeria national blindness and visual impairment survey

Abstract

BackgroundIn Nigeria, urbanisation and increasing life expectancy are likely to increase the incidence of non-communicable diseases. As the epidemic of diabetes matures, visual loss from diabetic retinopathy (DR) will increase unless mechanisms for early detection and treatment improve, and health systems respond to the growing burden of non-communicable diseases.MethodsA nationally-representative population-based sample of 13,591 participants aged ≥40 years selected by multistage-stratified-cluster-random-sampling with probability-proportional-to-size procedures were examined in 305 clusters in Nigeria between January 2005 to June 2007. All were asked about history of diabetes and underwent basic eye examination. Visual acuity (VA) was measured using logMAR E-chart. Participants with VA<6/12 and/or DR detected underwent detailed eye examination including dilated retinal examination and retinal photography. Systematic sampling of 1-in-7 gave a subsample (n=1759) examined in detail regardless of VA; and had random blood glucose (RBG) testing. Images were graded by Moorfields Eye Hospital Reading Centre. Participants were defined as having diabetes if they were previously diagnosed or RBG>11.1mmol/l or had DR. Data in the subsample were used to estimate the prevalence and to analyse risk factors for diabetes and DR using multivariable logistic regression. Additional information on the types of DR was obtained from participants not in the subsample.ResultsIn the subsample, 164 participants were excluded due to missing data; and 1,595 analysed. 52/1,595 had diabetes, a prevalence of 3.3% (95%CI 2.5-4.3%); and 25/52(48%) did not know. Media opacity in 8/52 precluded retinal examination. 9/44(20.5%) had DR. Higher prevalence of diabetes was associated with urban residence (Odds ratio [OR]1.87) and overweight/obesity (OR3.02/4.43 respectively). Although not statistically significant, DR was associated with hypertension (OR3.49) and RBG>15.0mmol/L (OR8.10). Persons with diabetes had 3 times greater odds of blindness. Of 11,832 other participants in the study sample, 175(1.5%) had history of diabetes; 28 had DR. Types of DR (total=37) included 10.8% proliferative, 51.4% macular oedema.ConclusionThe age-adjusted prevalence of diabetes in Nigeria was 3.25% (95%CI 2.50-4.30) and over 10% of people with diabetes aged ≥40 years had sight-threatening-DR. These data will enable the development of better public health strategies for the control of diabetes and planning services for DR to prevent vision loss.

Diabetes Mellitus and Its Associated Risk Factors among adult Population in Bisha Province, Southwest of Saudi Arabia

“…In the present study, we identified a combination of risk factors that associated with diabetes. Interestingly, the strong association of DM with several risk factors was observed in our study, which is in agreement with other studies in many parts of the world [10,12,24,25] (Valdez, Yoon, Liu, & Khoury, 2007;Zhao et al, 2012;Connor et al, 2013;Kyari et al, 2014). In the present study, the frequency of DM was slightly higher among men (14.7%) compared to women (10.8%).…”

“…Moreover, a relationship between growing per capita income and economic development on the increase in diabetes prevalence have been well documented (Sherif & Sumpio, 2015). The current published literatures shown that there are several risk factors related to the development of diabetes and its complications (Midhet, Al-Mohaimeed & Sharaf, 2010;Zhao et al, 2012;Salam & Siddiqui, 2013;Kyari et al, 2014). Hence, it is very important to determine associated risk factors to prevent or delay the onset of DM as well as to avoid the existence of life-threatening complications (Zhao et al, 2012).…”

Risk Factors of Retinopathy Among Diabetic’s Patients in Benin in 2014

“…Diabetes mellitus is a public health problem because of its increasing prevalence and the complications it creates [1]. These complications include the retinopathy that is the set of consecutive retinal lesions or related to diabetes.…”

Type 2 diabetes mellitus among the elderly in Goma, Democratic Republic of the Congo: prevalence, clinical features and complications

“…Nevertheless, the prevalence rate was higher in comparison to Ghana and Nigeria, and lower in comparison to Kenya, which could be due to differences in population size, exposures to risk factors and study designs [9,10,[17][18][19][20] respectively. This is a pattern observed in other studies in Africa, which could reflect the ageing population in Africa [8,17]. By contrast, in our study, this association was not statically significant.…”