Awareness of diabetic retinopathy among diabetes mellitus patients visiting a hospital of North India

Attitudes and practices related to hypoglycemia unawareness in patients with type 1 and type 2 diabetes

Diabetes is considered one of the most prevalent endocrine metabolic diseases. Monitoring hypoglycemia unawareness is an important component of routine diabetes care and can identify patients at increased risk of a severe hypoglycaemic event. This study aimed to evaluate the frequency of hypoglycemia unawareness and identify the factors contributing to its occurrence. A sample of 390 patients diagnosed with type 1 and type 2 diabetes was interviewed in an endocrine and diabetes center in Al-Ahsa city. Sociodemographic data, risk factors, and Clarke scores were used to evaluate the impairment of hypoglycemia awareness. Reduced awareness of hypoglycemia was found in 93 patients (23.8%). There were no statistically significant differences in the age of the patients, mean age of diagnosis, or cumulative glucose level between patients with awareness and those with reduced awareness (P > 0.05). Patients with type 2 diabetes mellitus (T2DM) showed significantly reduced awareness compared to type 1 diabetes (T1DM) (P = 0.038). Additionally, there were no statistically significant differences in hypoglycemia awareness between patients who underwent nephropathy screening and those who did not (P = 0.523). In conclusion, our study revealed reduced hypoglycemia awareness in 93 patients. However, there was no statistically significant difference related to various factors, including age and cumulative glucose levels. Patients with T2DM showed significantly lower hypoglycaemic awareness compared to patients with T1DM. Further research is needed to evaluate other factors of hypoglycemia unawareness.

The Evaluation of Diabetic Patients' Awareness of Diabetic Retinopathy and Its Complications in the Western Region of Saudi Arabia

Background Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia. Globally, 382 million people have diabetes mellitus, and 90% of these patients suffer from type 2 diabetes. Saudi Arabia has the second-highest prevalence of diabetes among all Middle Eastern countries. Diabetic retinopathy (DR) is a significant complication of diabetes; early detection and proper intervention are important for its management and prognosis. Aim This study aims to assess the awareness of diabetic patients of diabetic retinopathy symptoms and complications in the western region of Saudi Arabia. Methods This is a cross-sectional study in which a convenience sampling technique was implemented for collecting data from all patients who fulfilled the inclusion criteria within the timeframe between February 2022 and October 2022 among diabetic patients at the National Guard Health Affairs in the western region. We included both type 1 and type 2 diabetic participants who are older than 18 years of age and have at least one visit to any outpatient ophthalmology clinic. Results This study involved 259 participants. The mean age of the participants is 46.69 (standard deviation {SD}: 15.59). Type 2 was more prevalent among the applicants (58.3%). A total of 242 (93%) participants were aware that diabetes could affect their eyes. Surprisingly, 130 (50.2%) do not know about diabetic retinopathy therapy options. The most significant obstacle to being examined early for ophthalmological diseases among diabetic patients was the deficient knowledge of diabetic retinopathy. Also, a significant statistical relationship was found between the year of diagnosis and the level of awareness regarding eye complications. Conclusion Despite the high level of awareness of diabetic retinopathy among diabetic patients shown in our study, it did not correspond to a high level of self-awareness on the importance of preventive measures such as annual diabetic retinopathy screening.

Importance of Early Spotting of Diabetic Retinopathy in Type 2 Diabetes Patients by Family Medicine Physicians and Ophthalmologists: A Study in Jordan

BACKGROUND

Diabetes mellitus is a long-standing progressive disorder. Diabetic retinopathy is the primary cause of blindness among adults suffering from diabetes. Diabetic retinopathy is found to be dependent on the length of the period affected by diabetes, glucose control, blood pressure, and lipid profile while age, sex, and type of medical therapy were not found to be risk factors.  Aim: This study attempts to determine the importance of early spotting of diabetic retinopathy in Jordanian type 2 diabetes mellitus (T2DM) subjects by family medicine and ophthalmologist physicians, which will help us achieve better health outcomes.  Methods: Our retrospective investigation recruited 950 working-age subjects, of both sexes and with T2DM at three hospitals in Jordan, from September 2019 to June 2022. Early spotting of diabetic retinopathy was done by family medicine physicians and confirmation was done by ophthalmologists using direct ophthalmoscopy. Evaluation of the fundus by pupillary dilation was performed to assess the degree of diabetic retinopathy, macular edema, and the number of patients with diabetic retinopathy. The level of severity for diabetic retinopathy at confirmation was done using the classification for diabetic retinopathy produced by the American Association of Ophthalmology (AAO). Continuous parameters and independent t-tests were used to assess the average discrepancy in the degree of retinopathy among subjects. Categorical parameters were mentioned in numbers and percentages and chi-square tests were done to determine discrepancies in proportion among patients.   Results: Early spotting of diabetic retinopathy was recorded by family medicine physicians in 150 (15.8%) of 950 patients with T2DM of whom 56.7% (85/150) were women with an average age of 44 years. Of these 150 subjects with T2DM, who were presumed to have diabetic retinopathy, ophthalmologists diagnosed diabetic retinopathy in 35 patients (35/150; 23.3%). Of these, 33 (94.3%) had non-proliferative diabetic retinopathy and two (5.7%) had proliferative diabetic retinopathy. Of the 33 patients with non-proliferative diabetic retinopathy, 10 had mild non-proliferative diabetic retinopathy, 17 had moderate non-proliferative diabetic retinopathy, and six had severe non-proliferative diabetic retinopathy. Subjects aged more than 28 years had a 2.5 times increased risk of experiencing diabetic retinopathy. Awareness and lack of awareness values differed significantly (316 (33.3%), 634 (66.7%); P<0.05, respectively).  Conclusions: Early spotting of diabetic retinopathy by family medicine physicians shortens the delay of diagnosis confirmation by ophthalmologists.

An Assessment on the Awareness of Diabetic Retinopathy Among Participants Attending the Diabetes Awareness Camp in Saudi Arabia

Aim The objective of this study is to assess the level of awareness of the effect of diabetes and diabetic retinopathy (DR) on the eye among a sample of the Jeddah community. Methods A cross-sectional study was conducted among those attending a diabetes awareness camp in Jeddah, Saudi Arabia, in November 2021. Participants were asked to answer questions in a structured questionnaire that was already used in a previous study. Responses were analyzed using Statistical Package for the Social Sciences (SPSS) version 25 (IBM SPSS Statistics, Armonk, NY, USA). Results A total of 352 participants were included in this study, 184 (52.3%) of them were females. Of the participants, only 74 (21%) had diabetes mellitus (DM). The vast majority (94%) of the participants believed that diabetes could affect the eyes, and 94.3% believed that maintaining the level of blood sugar could maintain the eye and the level of vision. Moreover, 77.3% were aware that diabetes could lead to visual impairment and blindness. Around one-third of the total participants and less than half of the diabetic group were found familiar with DR. Although 96% of diabetic participants reported the need for diabetics to get their eyes checked annually, only 70% did so. Lack of awareness of the effect of diabetes on the retina was the main barrier preventing diabetic groups from getting their eye checked. Conclusion Despite the good level of awareness among the community and diabetics about diabetes and its effect on the eyes, there is less awareness that DR is one of the most dangerous complications that lead to visual impairments. These findings assure the importance to raise awareness of DR among the community and diabetics and increase awareness of the importance of annual eye examinations.