Dataset Information

Prevalence of Diabetic Retinopathy in Undiagnosed Diabetic Patients: A Nationwide Population-Based Study.

ABSTRACT:

Background

We investigated the prevalence of diabetic retinopathy (DR) in patients with undiagnosed diabetes through a nationwide survey, compared to those with known diabetes.

Methods

Among the participants of the Korean National Health and Nutrition Examination Surveys (KNHANES) from 2017 to 2018, individuals aged ≥40 years with diabetes and fundus exam results were enrolled. Sampling weights were applied to represent the entire Korean population. Newly detected diabetes patients through KNHANES were classified under "undiagnosed diabetes."

Results

Among a total of 9,108 participants aged ≥40 years, 951 were selected for analysis. Of them, 31.3% (standard error, ±2.0%) were classified under "undiagnosed diabetes." The prevalence of DR in patients with known and undiagnosed diabetes was 24.5%±2.0% and 10.7%±2.2%, respectively (P<0.001). The DR prevalence increased with rising glycosylated hemoglobin (HbA1c) levels in patients with known and undiagnosed diabetes (P for trend=0.001 in both). Among those with undiagnosed diabetes, the prevalence of DR was 6.9%±2.1%, 8.0%±3.4%, 5.6%±5.7%, 16.7%±9.4%, and 42.6%±14.8% for HbA1c levels of <7.0%, 7.0%-7.9%, 8.0%-8.9%, 9.0%-9.9%, and ≥10.0% respectively. There was no difference in the prevalence of hypertension, dyslipidemia, hypertriglyceridemia, or obesity according to the presence or absence of DR.

Conclusion

About one-third of patients with diabetes were unaware of their diabetes, and 10% of them have already developed DR. Considering increasing the prevalence of DR according to HbA1c level was found in patients with undiagnosed diabetes like those with known diabetes, screening and early detection of diabetes and DR are important.

SUBMITTER: Jang HN

PROVIDER: S-EPMC9353559 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Prevalence of Diabetic Retinopathy in Undiagnosed Diabetic Patients: A Nationwide Population-Based Study.

Jang Han Na HN Moon Min Kyong MK Koo Bo Kyung BK

Diabetes & metabolism journal 20220223 4

<h4>Background</h4>We investigated the prevalence of diabetic retinopathy (DR) in patients with undiagnosed diabetes through a nationwide survey, compared to those with known diabetes.<h4>Methods</h4>Among the participants of the Korean National Health and Nutrition Examination Surveys (KNHANES) from 2017 to 2018, individuals aged ≥40 years with diabetes and fundus exam results were enrolled. Sampling weights were applied to represent the entire Korean population. Newly detected diabetes patient ...[more]

PMID: 35193173

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Project description:BackgroundDiabetic retinopathy is the most common microvascular complication of diabetes mellitus on eye and it is the leading cause of visual impairment among productive segment of the population. Globally, the prevalence of diabetic retinopathy is reported to be 27%. In Ethiopia, sufficient data is lacking on the prevalence of diabetic retinopathy as well as information on its predisposing factors. The study was required to assess the prevalence of diabetic retinopathy and its predisposing factors in diabetic patients attending at a General Hospital in Ethiopia.MethodsAn institution based cross sectional study was employed on 331 diabetic patients recruited with a systematic random sampling technique. Data were collected through structured questionnaire, tracing patients' medical folder and ocular health examination. Data were analyzed with Statistical Package for Social Science Version 20. Logistic regression methods of analysis were used to figure out predisposing factors of diabetic retinopathy. Adjusted odds ratio with 95% confidence interval was used to determine the strength of association.ResultA total of 331 diabetic patients completed the study with a response rate of 99.10%. The median duration of diabetes was 5 years. The prevalence of diabetic retinopathy was 34.1% (95%Confidence Interval (CI): 28.7%-39.3%). Low family monthly income (Adjusted Odds Ratio (AOR) = 7.43, 95% CI: 2.44-22.57), longer duration of diabetes (AOR = 1.44, 95% CI: 1.30-1.58), poor glycemic control (AOR = 4.76, 95%CI: 2.26-10.00), and being on insulin treatment alone (AOR = 3.85, 95%CI: 1.16-12.74) were independently associated with diabetic retinopathy.Conclusion and recommendationThe prevalence of diabetic retinopathy was 34.1%, higher than national and global figures. Low family monthly income, longer duration of diabetes, poor glucose control and being on insulin treatment alone were important risk factors of diabetic retinopathy. Proper diabetes self management and early screening of diabetic retinopathy in all diabetic patients were recommended.

Project description:Background and Objectives: Fenofibrate, a PPAR-α agonist, has been demonstrated to reduce the progression of diabetic retinopathy (DR) and the need for laser treatment in a FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study. However, in the subgroup of patients without pre-existing DR, there was no significant difference in the progression of DR between the fenofibrate group and the placebo group. In this study, we aim to investigate whether fenofibrate can decrease the risk of incident DR in a population-based cohort study of type 2 diabetic patients in Taiwan. Materials and Methods: A total of 32,253 type 2 diabetic patients without previous retinopathy were retrieved from 892,419 patients in 2001-2002. They were then divided into two groups based on whether they were exposed to fenofibrate or not. The patients were followed until a diagnosis of diabetic retinopathy was made or until the year 2008. Results: With a follow-up period of 6.8 ± 1.5 years and 5.4 ± 2.6 years for 2500 fenofibrate users and 29,753 non-users, respectively, the Cox proportional hazard regression analysis revealed that the hazard ratio (HR) of new onset retinopathy was 0.57 (95% CI 0.57-0.62, p < 0.001). After adjusting for hypertension; the Charlson comorbidity index (CCI); and medications such as angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), anticoagulants, gemfibrozil, statins, and hypoglycemic agents, the adjusted HR was 0.75 (95% CI 0.68-0.82, p < 0.001). The need for laser treatment has an HR and adjusted HR of 0.59 (95% CI 0.49-0.71, p < 0.001) and 0.67 (95% CI 0.56-0.81, p < 0.001), respectively. Conclusion: Our study showed that the long-term and regular use of fenofibrate may decrease the risk of incident retinopathy and the need for laser treatment in type 2 diabetic patients. Since there are limitations associated with our study, further investigations are necessary to confirm such an association.

Project description:Research questionThe current population-based study aimed to investigate the prevalence of diabetic retinopathy (DR) and risk factors among residents over 40 years old in the rural area of Dongguan, southern China.Study designThe Dongguan Eye Study was a population-based study from September 2011 to February 2012.SettingThe area was set in the rural area of Dongguan, southern China.ParticipantsAdult rural population aged 40 or older.InterventionParticipants underwent haematological, physical, ophthalmic examinations and completed a questionnaire regarding lifestyles and systemic medical conditions.Primary and secondary outcome measuresThe frequency and risk factors of visual impairment and the major vision-threatening eye diseases.ResultsOf the 8952 Han Chinese, 1500 were diagnosed with type 2 diabetes mellitus (T2DM) with an average age of 59.5±11.1 years, and 1310 participants with fundus photography results were analysed. Standardised prevalence rate of DR was 18.2% for all patients with diabetes, 32.8% for the patients with previously diagnosed diabetes and 12.6% for newly diagnosed patients with T2DM. The prevalence rate of male DR was significantly higher than that of female DR (23.0% vs 14.1%, p<0.001). No significant difference was found in age-specific prevalence of DR. In diabetic patients, the prevalence rates of vision-threatening diabetic retinopathy, diabetic macular oedema and clinically significant macular oedema were 2.5%, 2.8% and 0.9%, respectively. Male gender, higher education level, longer duration of diabetes mellitus (DM), higher systolic blood pressure and glycosylated haemoglobin were independent risk factors for DR development in patients with diabetes.ConclusionA relatively lower prevalence of DR was found among the participants with T2DM in residents over 40 years in the rural area of southern China. Thus, an ophthalmic examination is recommended, especially for individuals with DM and DR risk factors. There is a need to increase awareness and education on DM and DR, especially in subjects with DR risk factors to reduce the incidence of DR and macular oedema.

Dataset Information

Prevalence of Diabetic Retinopathy in Undiagnosed Diabetic Patients: A Nationwide Population-Based Study.

Background

Methods

Results

Conclusion

Publications

Prevalence of Diabetic Retinopathy in Undiagnosed Diabetic Patients: A Nationwide Population-Based Study.

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