June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
An Estimation of the Prevalence of Diabetes Mellitus and Diabetic Retinopathy Amongst Adults in Timor-Leste
Author Affiliations & Notes
  • Rosie Dawkins
    Sentru Matan Nasional, Hospital Nacional Guido Valadares, Dili, Timor-Leste
    East Timor Eye Program, Royal Australasian College of Surgeons, East Melbourne, VIC, Australia
  • Genevieve F Oliver
    Sentru Matan Nasional, Hospital Nacional Guido Valadares, Dili, Timor-Leste
    East Timor Eye Program, Royal Australasian College of Surgeons, East Melbourne, VIC, Australia
  • Manoj Sharma
    Sentru Matan Nasional, Hospital Nacional Guido Valadares, Dili, Timor-Leste
    East Timor Eye Program, Royal Australasian College of Surgeons, East Melbourne, VIC, Australia
  • Basilio Pinto
    Sentru Matan Nasional, Hospital Nacional Guido Valadares, Dili, Timor-Leste
    Fred Hollows Foundation of New Zealand, Auckland, New Zealand
  • Belmerio Jeronimo
    Sentru Matan Nasional, Hospital Nacional Guido Valadares, Dili, Timor-Leste
    Fred Hollows Foundation of New Zealand, Auckland, New Zealand
  • Julia Magno
    Sentru Matan Nasional, Hospital Nacional Guido Valadares, Dili, Timor-Leste
  • Bernadete Pereira
    Sentru Matan Nasional, Hospital Nacional Guido Valadares, Dili, Timor-Leste
  • Lara Motta
    International Centre for Point-of-Care Testing, Flinders University, Adelaide, SA, Australia
  • Nitin Verma
    East Timor Eye Program, Royal Australasian College of Surgeons, East Melbourne, VIC, Australia
    Ophthalmology, University of Tasmania, Hobart, TAS, Australia
  • Mark Shephard
    International Centre for Point-of-Care Testing, Flinders University, Adelaide, SA, Australia
  • Footnotes
    Commercial Relationships Rosie Dawkins, None; Genevieve Oliver, None; Manoj Sharma, None; Basilio Pinto, None; Belmerio Jeronimo, None; Julia Magno, None; Bernadete Pereira, None; Lara Motta, Siemens (F); Nitin Verma, None; Mark Shephard, Siemens (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1451. doi:
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      Rosie Dawkins, Genevieve F Oliver, Manoj Sharma, Basilio Pinto, Belmerio Jeronimo, Julia Magno, Bernadete Pereira, Lara Motta, Nitin Verma, Mark Shephard; An Estimation of the Prevalence of Diabetes Mellitus and Diabetic Retinopathy Amongst Adults in Timor-Leste. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1451.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Once considered an affliction of rich countries, diabetes mellitus is increasingly seen throughout the world. One of the serious microvascular complications of diabetes mellitus is diabetic retinopathy, an important cause of blindness worldwide.<br /> <br /> This study aims to estimate the prevalence of diabetes, and diabetic retinopathy, in Timor-Leste, one of the world’s newest and poorest countries.

 
Methods
 

Data collection took place March 2013 to May 2014 at the Sentru Matan Nasional (National Eye Centre) in Dili, Timor-Leste. Patients being assessed for cataract surgery had a point-of-care HbA1c measurement. Ocular examination, blood pressure, demographic, medical and family history data were also collected.

 
Results
 

A total of 283 patients were included. The mean age was 63.6 years (range 20-90 years). The mean HbA1c was 6.1%, range 4.2-14.0.<br /> <br /> Forty-three patients (15.2%) were identified as having diabetes mellitus. The mean HbA1c in this subset was 9.5%. Of patients identified with diabetes, 62.8% were newly diagnosed. Of those with known diabetes, 68.8% were receiving treatment of any kind including lifestyle modification, and the mean duration of known disease was 4.9 years.<br /> <br /> Diabetic retinopathy was identified in 8 patients (18.6%), of whom half had no previous diagnosis of diabetes. No proliferative diabetic retinopathy was found, though severe non-proliferative diabetic retinopathy was found in one patient who had not previously been diagnosed with diabetes.

 
Conclusions
 

This study estimates the prevalence of diabetes at 15% in adults in Timor-Leste, with a prevalence of retinopathy of 19% amongst people with diabetes. Although this likely represents an over-estimate, due to the age of the population tested and the relationship of cataract to diabetes, our estimate is in line with regional estimates and indicates that diabetes is an important potential source of blindness, as well as mortality, in Timor-Leste.<br /> <br /> With the majority of people with diabetes undiagnosed, point-of-care testing is a valuable tool. Further investment is required in expanding testing, as well as in prevention and treatment, as well as screening for and treatment of diabetic retinopathy. Diabetes presents an important challenge for a fragile health system, and along with other non-communicable diseases, a threat to hard-won economic gains.

 
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