Abstract
BackgroundDiabetic retinopathy has a significant impact in every healthcare system. Despite that fact, there are few accurate estimates in the prevalence of DR in Brazil’s different geographic regions, particularly proliferative DR and diabetic macular edema. This study aims to determine the prevalence of diabetic retinopathy in Brazil’s five continental regions and its determinant factors.MethodsThis multi center, cross-sectional, observational study, conducted between August 2011 and December 2014, included patients with type 1 diabetes from the 5 Brazilian geographic regions (South, Southeast, North, Northeast and Midwest). During a clinical visit, a structured questionnaire was applied, blood sampling was collected and each patient underwent mydriatic binocular indirect ophthalmoscopy evaluation.ResultsData was obtained from 1644 patients, aged 30.2 ± 12 years (56.1% female, 54.4% Caucasian), with a diabetes duration of 15.5 ± 9.3 years. The prevalence of diabetic retinopathy was 242 (36.1%) in the Southeast, 102 (42.9%) in the South, 183 (29.9%) in the North and Northeast and 54 (41.7%) in the Midwest. Multinomial regression showed no difference in the prevalence of non-proliferative diabetic retinopathy in each geographic region, although, prevalence of proliferative diabetic retinopathy (p = 0.022), and diabetic macular edema (p = 0.003) was higher in the Midwest. Stepwise analyses reviled duration of diabetes, level of HbA1c and hypertension as independent variables.ConclusionsThe prevalence of non proliferative diabetic retinopathy in patients with type 1 diabetes was no different between each geographic region of Brazil. The Midwest presented higher prevalence of proliferative diabetic retinopathy and diabetic macular edema. Duration of DM and glycemic control is of central importance to all. Hypertension is another fundamental factor to every region, at special in the South and Southeast. Glycemic control and patients in social and economic vulnerability deserves special attention in the North and Northeast of Brazil.
Highlights
Diabetic retinopathy has a significant impact in every healthcare system
Data are presented as the means (SD) and n (%) F female a African-Brazilians, Mulattos, Asians, Native Indian care accounted for 63.0% of the patients enrolled
Adjusting our model to investigate actual differences in the prevalence of Diabetic retinopathy (DR) between the five geographic regions of Brazil, we found no variation in the matter of non-proliferative DR (NPDR)
Summary
Diabetic retinopathy has a significant impact in every healthcare system. There are few accurate estimates in the prevalence of DR in Brazil’s different geographic regions, proliferative DR and diabetic macular edema. This study aims to determine the prevalence of diabetic retinopathy in Brazil’s five continental regions and its determinant factors. Diabetic retinopathy (DR) has a significant impact in the health care system. It is the leading cause of blindness among working-aged adults worldwide [1]. As a major public health problem causes productivity losses due to early retirement, suffering and diminishing quality of life, for millions of people. In Brazil, early retirement in patients due to diabetes-related chronic complications
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