Abstract
ackground: Diabetic retinopathy (DR) is the fourth leading cause of blindness and is a major contributor to visual impairment after cataract, glaucoma and age-related macular degeneration. Globally, 55% of patients with diabetes are likely to suffer from DR. Aim: To determine the prevalence and risk factors associated with DR amongst type II diabetic patients. Setting: The study was conducted at a non-governmental eye clinic between March and December 2017 in the eThekwini district of KwaZulu-Natal. Methods: Patients’ demographic and clinical data were obtained through randomised systematic sampling from the medical records of 298 patients. Univariate analysis followed by multivariate logistical analysis was used to test the associations. Results: In all, 42% of the sampled patients had DR, with 98% (122 patients) displaying DR in both eyes. The mean age of DR patients was 64 years (standard deviation [SD]: 9.34), with a female ( n = 97) predominance. Patients with diabetes for > 10 years (odds ratio [OR]: 2.53; 95% confidence interval [CI]: 1.39–4.62), comorbidity with hypertension (OR: 7.43; 95% CI: 1.57–35.28), and presence of cardiovascular diseases (OR: 4.3; 95% CI: 2.49–7.44) were significant risk factors for DR, whilst an elevated cholesterol level showed an increased but non-significant risk. Conclusion: Diabetic retinopathy was higher in this study than the global estimated prevalence. Lifestyle diseases and its associated modifiable risk factors are important contributors to the development of DR. A holistic approach towards diabetes, which includes primary prevention and aggressive management and control of hypertension, diabetes, elevated cholesterol, and cardiovascular diseases, is required to reduce the incidence of diabetes retinopathy.
Highlights
Estimates from the International Diabetes Federation have indicated that in South Africa, 3.5 million people aged between 20 and 79 years were diagnosed with diabetes equalling almost 7% of the population,[1] with this number increasing to 4.5 million people in 2019.2
The impact of diabetes on the health services is because of the high burden of diabetic patients and because of the increasing complications associated with poor blood glucose control
The major long-term complications associated with diabetes are macrovascular and microvascular
Summary
The impact of diabetes on the health services is because of the high burden of diabetic patients and because of the increasing complications associated with poor blood glucose control. Poor blood glucose control is associated with long-term complications because of damage, dysfunction and failure of different organs. 55% of diabetics are likely to suffer from DR.[4] In South Africa, the prevalence of DR was estimated to be between 5% and 10%5 and is the fourth leading cause of blindness after cataract, glaucoma and agerelated macular degeneration.[6] In addition, DR is the major contributor to visual impairment after refractive errors, cataract and glaucoma.[6]. Diabetic retinopathy (DR) is the fourth leading cause of blindness and is a major contributor to visual impairment after cataract, glaucoma and age-related macular degeneration. 55% of patients with diabetes are likely to suffer from DR
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