Frequency of Diabetic Retinopathy and Factors for Suboptimal Diabetic Control in Type 2 Diabetic Patients in a Trust Hospital of Pakistan

http://doi.org/10.36351/pjo.v37i2.1123

Abstract

Purpose:  To find out the frequency of diabetic retinopathy and factors responsible for poor diabetic control in patients with type 2 diabetes in a trust hospital.

Place and duration of Study:  Akhtar Saeed Medical College, from January 2018 to December 2019.

Study Design:  Descriptive cross-sectional study.

Methods:  Total 395 diabetic patients belonging to lower socioeconomic class were included in the study. Type 1diabetes, age below 20 years, high myopia, papilledema, dense cataract, corneal scar and patients on dialysis were excluded. Age, gender, duration of disease, family history of diabetes, drugs used for diabetic control, compliance with drug, random serum sugar level at presentation, HBA1c level, best corrected visual acuity, slit lamp and fundus findings were noted.

Results:  There were 270 (68.4%) females and 125 (31.6%) males (total 395). Random serum sugar was below 200mg/dl in 188 (47.6%). Family history of diabetes was positive in 145 (36.7%). Duration of diabetes was below ten years in 288 (73%). Visual acuity was less than 6/60 in 36 (6.3%) patients. HbA1c was within normal range in only 124 (31.4%). CSMO was present in 199 (50.37%) patients. Diabetic retinopathy was observed in 57 (14.43%) patients. Patients using oral hypoglycemic agents were 225 (57%), on insulin 151 (38.23%) and19 (4.8%) were using both oral drugs and insulin. Compliance was poor in 294 (74.4%).

Conclusion:  Poor monetary resources compounded with lack of knowledge about disease, misconceptions regarding insulin and imbalanced diet are big hurdles in achieving optimal glycemic control in lower socio-economic class.

Key Words:  Diabetic Retinopathy, glycated hemoglobin (HbA1c), blood serum sugar, clinically significant macular edema.