Abstract
BackgroundDiabetes mellitus (DM) is a common systemic disease amongst Black South Africans. It may lead to diabetic retinopathy (DR), a common cause of visual impairment (VI) and blindness. DR may significantly increase the prevalence of VI and blindness.AimTo assess risk factors for VI and blindness amongst a black diabetic South African population aged ≥ 40 years.SettingThe study was conducted in seven Government healthcare facilities (two hospitals, four clinics and one health centre) in Mopani District, Limpopo province, South Africa.MethodsThis was a cross-sectional health facility-based quantitative study. Structured interviews were used to obtain information, which included sociodemographic profile, knowledge about DM and its ocular complications, presence of hypertension and accessibility to health facilities. Subsequently participants were examined for VI and blindness using an autorefractor, pinhole disc, ophthalmoscope and logMAR visual acuity chart. Anthropometric measurements (height, weight and waist) were also taken. Associations between 31 risk factors and VI as well as blindness were statistically examined.ResultsParticipants (N = 225) included 161 women and 64 men aged 40–90 years (mean 61.5 ± 10.49 years); 41.3% of them had VI and 3.6% were blind. Cataracts (76.8%) and DR (7.1%) were the common causes of compensated VI and blindness. Risk factors that were associated with VI and blindness were age, monthly income, compliance with losing weight and physical activity.ConclusionFindings suggest that lifestyle intervention and appropriate eyecare programmes may reduce VI and blindness in this population.
Highlights
Diabetes mellitus (DM) is a common metabolic disorder characterised by sustained hyperglycaemia of varying severity secondary to lack and/or diminished efficacy of endogenous insulin.[1]
Risk factors that were associated with visual impairment (VI) and blindness were age, monthly income, compliance with losing weight and physical activity
The prevalence of VI and blindness ranged from 0.9% amongst those aged 40–44 years to 29.3% amongst those aged ≥ 60 years (Figure 1)
Summary
Diabetes mellitus (DM) is a common metabolic disorder characterised by sustained hyperglycaemia of varying severity secondary to lack and/or diminished efficacy of endogenous insulin.[1] Based on aetiology DM can be classified into type 1 (insulin-dependent) DM, type 2 (noninsulin-dependent) DM, gestational DM, and other specific types of DM.[2] Type 1 DM (T1DM), which accounts for only 5% – 10% of all types of DM, results from a cellular-mediated auto-immune destruction of β-cells of the pancreas This cell destruction leads to absolute insulin deficiency and dependence on exogenous insulin for survival.[3] Type 2 DM (T2DM) accounts for about 90% – 95% of all types of DM and results from insulin resistance and relative insulin deficiency.[3] T2DM can be controlled through healthy diet, participating in physical activities, losing excess weight and taking oral medication.[4] Gestational DM occurs only during pregnancy and is a risk factor for T2DM after pregnancy.[5] Other specific types of DM may be due to other causes such as genetic defects in β-cell function, insulin action, diseases of the pancreas, and drug-(such as HIV medication)or chemicalinduced DM.[3]. DR may significantly increase the prevalence of VI and blindness
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