June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Self-help, lifestyle and awareness influence sight-threatening retinopathy in patients attending diabetic eye clinics in India and Nepal
Author Affiliations & Notes
  • Raju P Sapkota
    Vision and Eye Research Unit (VERU), Postgraduate Medical Institute, Faculty of Medical Science, Anglia Ruskin University, Cambridge, United Kingdom
  • Tirthalal Upadhyaya
    Department of Medicine, Gandaki Medical College Teaching Hispital, Pokhara, Nepal
  • Govind Gurung
    Department of Ophthalmology, Gandaki Medical College Teaching Hospital, Pokhara, Nepal
  • Anupama Biswas
    Department of Ophthalmology, Kurseong Sub-divisional Hospital, Darjeeling, India
  • Durgasri Jaisankar
    Sankara Netralaya Eye Hospital, Chennai, India
  • Rajiv Raman
    Sankara Netralaya Eye Hospital, Chennai, India
  • Shahina Pardhan
    Vision and Eye Research Unit (VERU), Postgraduate Medical Institute, Faculty of Medical Science, Anglia Ruskin University, Cambridge, United Kingdom
  • Footnotes
    Commercial Relationships   Raju P Sapkota, None; Tirthalal Upadhyaya, None; Govind Gurung, None; Anupama Biswas, None; Durgasri Jaisankar, None; Rajiv Raman, None; Shahina Pardhan, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 70. doi:
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      Raju P Sapkota, Tirthalal Upadhyaya, Govind Gurung, Anupama Biswas, Durgasri Jaisankar, Rajiv Raman, Shahina Pardhan; Self-help, lifestyle and awareness influence sight-threatening retinopathy in patients attending diabetic eye clinics in India and Nepal. Invest. Ophthalmol. Vis. Sci. 2017;58(8):70.

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

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Abstract

Purpose : To examine the relationship between various clinical/non-clinical risk factors of diabetes and retinopathy severity. Whilst the relationship between diabetic retinopathy and various clinical variables is known, any possible associations with non-clinical parameters such as self-help, lifestyle and awareness are not well established (Baradaran HR, et al. BMC Publ Health 2006).

Methods : 600 patients attending diabetic eye clinics in three hospitals (200 consecutive patients from Pokhara, Nepal; Chennai and Darjeeling, India) took part. Clinical data included HbA1c, fasting blood sugar (FBS), blood pressure (BP), and the severity of retinopathy. Non-clinical data included age, duration, knowledge about diabetes/its control, self-help regimes, lifestyle, etc. collected using a structured questionnaire. Sight-threatening retinopathy (STR) was classified as ≥ moderate non-proliferative retinopathy using the ETDRS classification. Univariate analysis was performed and significant variables were used to fit a multiple logistic regression model.

Results : The majority of patients had Type 2 diabetes (96%). STR was found in 20% patients. HbA1c, FBS, age, diabetic duration and systolic BP were significantly associated with retinopathy severity (p≤0.05). Non-clinical variables including reduced literacy level, inadequate self-help (ie. not attending appointments, forgetting to take medicine), decreased awareness of the importance of diabetic control and poor lifestyle (drinking alcohol, inadequate exercise) were also significantly associated with STR (p≤0.02). Logistic regression retained a number of variables with HbA1c (Odds Ratio, OR=1.4, p<0.01, duration of diabetes (OR=4.6, p<0.01), knowledge about control of diabetes (OR=6.1, p<0.01), number of missed appointments (OR=1.9, p=0.03), and the number of hours exercised per week (OR=8.84, p =0.05) being the most significant.

Conclusions : Despite the fact that patients were attending an eye clinic, a significant proportion were not aware of the possible eye complications of poorly controlled diabetes. In addition our data show that lack of knowledge and poor diabetic control is significantly associated with STR. These findings further highlight the importance of improved knowledge, self-help and lifestyle measures in order to reduce diabetic retinal complications.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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