Prevalence of diabetic retinopathy and influence factors among newly diagnosed diabetics in rural and urban areas of Pakistan: data analysis from the Pakistan national blindness and visual impairment surgery 2003

ABSTRACT

To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabetics from the data set of Pakistan National Blindness survey 2003. We analyzed the data collected from the Pakistan National Blindness Survey, a population based survey with regards to diabetic retinopathy and its risk factors. Descriptive information for each of the variable was derived and distribution was assessed by simple tabulation and cross tabulation. We used Odds Ratio [using Mantel-Haenszel technique] and 95% confidence interval to assess association between the variables. Among the 16507 subjects [95.3% response rate] 660 [4%] were found to be diabetic. Out of these, one hundred one [15.3%] had diabetic retinopathy. We found a low prevalence of diabetic retinopathy [0.6%] among the subjects aged 30 and above. The risk of diabetic retinopathy was higher in urban diabetic subjects [OR 2.7, with 95% CI 1.08-4.1] as compared to rural areas of Sindh. In addition it was higher in hypertensive [OR 2.77 with 95% CI 1.0-4.1] and in obese [OR 2.2 with 95% CI 1.7-4.2] as compared to subjects with normal body mass index [BMI]. The prevalence of blindness in diabetic subjects was 5.9%. There were three hundred forty four [52%] subjects with diabetes with normal vision, 149[22%] subjects were with moderate visual impairment, thirty six [5.9%] subjects were blind and twenty two [3.3%] subjects were with severe visual impairment. About 214 diabetics have hypertension [32.4%], one hundred forty one [21.3%] diabetics are obese. Our study data suggests lower prevalence of Diabetic Retinopathy as compared to other part of the region. There is great need to collect and monitor epidemiological data at district hospital level in order to develop a national annual retinal screening program for diabetic patients in Pakistan