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Sunita Mohan, Arvind Kumar Singh, Radhika Srinivasan, Sundaram Natarajan, Govindasamy Kumaramanickavel, Catherine A McCarty, Aditya Jyot Diabetic Retnopathy in Urban Mumbai Slums Study (AJDRUMSS); AJDRUMSS: Prevalence of Diabetic Retinopathy in Type 2 Diabetes Mellitus from the Urban Slums of Mumbai, India.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1450.
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© ARVO (1962-2015); The Authors (2016-present)
To estimate and characterise the prevalence of diabetic retinopathy (DR) from the urban slums of Mumbai, a city in western India for which no data is available.
Aditya Jyot Diabetic Retinopathy in Urban Mumbai Slums Study (AJDRUMSS), is an ongoing prospective cross-sectional study conducted in non-randomly selected seven wards of urban slums of Mumbai during the time period January 2011-June 2014. The target population, aged > 40 years, after being diagnosed with type 2 diabetes mellitus (T2DM) based on door to door survey and field fasting blood sugar (FBS) estimation with cut off as FBS > 126 mg/dl, underwent comprehensive ophthalmic evaluation, anthropometry and dilated fundus photography for retinopathy evaluation followed by a counselling for life style modification. Knowledge, attitude and practice (KAP) assessment was done pre and post the ophthalmic evaluation & counselling to assess the impact of the study.
A total of 6520 eligible subjects were enumerated of which 6362 subjects (response rate 97.58%) consented for FBS estimation. The age-sex-BMI-hypertension-residence adjusted prevalence of DM & DR for the study population was estimated as 11.06% & 1.56% respectively. The percentage of DR amongst the T2DM was 16.78%. Amongst total T2DM subjects the percentage of DR in Known Diabetes (KD) was 18.7% (n=513) and 6.3% (n=95) in NDD (Newly Diagnosed Diabetes) which was significantly associated with the presence of DR, p=0.007, OR 3.29 (95 % Confidence Interval(CI)1.38-7.81). The FBS > 126 mg % did not show any significant association with presence of DR in T2DM subjects with and without DR, p=0.908, OR; 0.97(95% CI 0.60-1.58). The KAP assessment revealed a statistically significant (p<0.001) increase in knowledge about DM affecting the eyes (47.11% pre vs. 87.27% post); similarly, significantly higher (p<0.001) number of subjects believed that eye examination should be conducted as soon as possible after diagnosis of DM (35.32% pre vs. 93.19% post).
The prevalence of DR was established in the city of Mumbai, western India where approximately every 1 in 5 T2DM subjects showed evidence of DR. Increasing awareness in such communities increases the acceptance of the services and helps in better penetration of health care facilities.
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