Abstract
Abstract: :
Purpose: To determine the rate of compliance with vision care guidelines and the factors associated with compliance in a population-based sample of adult, diabetic Latinos. Methods: The LALES is a population-based study assessing the prevalence of eye disease in non-institutionalized Latinos, aged 40 years and older. As part of the examination, each participant underwent an interview regarding sociodemographics, history of eye disease, and self-reported utilization of eye care. All diabetics were specifically asked questions regarding health and vision care utilization and self-care. The utilization of eye care by the diabetics was compared to the American Diabetes Association (ADA) guidelines for vision care. ADA guidelines recommend that type 2 diabetics have a dilated eye examination (DEE) at diagnosis, and yearly thereafter. Compliance was defined as participants reporting having had a DEE in the 12 months preceding the LALES examination. Non-compliance was defined as either never having had a DEE, or having had the last DEE more than 12 months ago. Logistic regression was used to calculate odds ratios to evaluate the association between socio-demographic and ocular factors and the likelihood of compliance with ADA guidelines. Results: Of the 787 participants who self-reported having diabetes 273 (34.7%) reported complying with ADA vision care guidelines. Regression analysis suggested that factors that were independently associated with compliance included older age (OR=1.02, p=0.04), having graduated from high school (OR=1.54, p=0.02), having health insurance (OR=1.79, p=0.05), having vision insurance (OR=1.42, p=0.17), history of glaucoma (OR=2.79, p<0.004), history of cataract (OR=1.58, p=0.04), diagnosis of severe diabetic retinopathy (OR=2.87, p<0.0001), and history of diabetes treatment (OR=2.81, p<0.01). Conclusions: Approximately two thirds of the adult Latino diabetics in this cohort are not complying with recommended guidelines for eye care. Since complying with these is likely to delay or reduce ocular morbidity and blindness associated with diabetes, intervention programs aimed at improving the educational status and provision of health and vision insurance may improve the ocular outcomes and reduce blindness associated with diabetes in Latinos.
Keywords: diabetes • clinical (human) or epidemiologic studies: tre • clinical (human) or epidemiologic studies: hea