Abstract
Purpose:
To evaluate the proportion of diabetic retinopathy (DR) among self reported known type 2 diabetics mellitus (KD) patients and study the risk factors associated with it in the urban slums of Mumbai, India. KD was defined as clinical diagnosis of DM made prior to the survey or patient using hypoglycemic medication, either oral or insulin or both.
Methods:
A cross sectional survey of eligible subjects aged 40 years or above was conducted in four non-randomly selected wards of urban slums of the city of Mumbai, Maharashtra state, India. Eligible subjects were enumerated through a door to door survey by community health workers. History of diabetes in terms of duration and family history was elicited, height, weight, and blood pressure were measured for all subjects. Screening camps were organised for modern comprehensive ocular examinations including visual acuity and anterior and posterior segments examination at the study areas by experienced ophthalmologists.
Results:
A total of 3596 eligible subjects were enumerated between January - February 2012 in the study area. The prevalence of KD was 5.8% (n=230) and of diabetic retinopathy among the known diabetics was 22.6% (n=52). Duration of diabetes and hypertension (p value <0.05) were strongly associated with DR. The most common form of retinopathy was non-proliferative DR, 94.2% (n=49) and sight threatening retinopathy requiring intervention was 5.8% (n=3).
Conclusions:
The proportion and morbidity of DR in self reported KD in the urban slum Mumbai population was comparable to that of the urban society anywhere in the world. Collectively, India being the diabetic capital of the world, with its rapid urbanization and rising number of slums with poor health surveillance, could spell a major health disaster in the years to come.
Keywords: 459 clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology •
499 diabetic retinopathy •
463 clinical (human) or epidemiologic studies: prevalence/incidence