Knowledge of diabetes and diabetic retinopathy among rural populations in India, and the influence of knowledge of diabetic retinopathy on attitude and practice.

INTRODUCTION: Diabetes mellitus, particularly type II, is a major public health concern worldwide. While the occurrence of diabetic retinopathy cannot be prevented, with the provision of knowledge to sufferers, sight-threatening complications can be minimized. PURPOSE: To report the results of a KAP (Knowledge, Attitude and Practice) study among a rural population in two areas: diabetes mellitus (DM) and diabetic retinopathy (DR). The level of knowledge was evaluated for both DM and DR; however, the influence of knowledge on practices and attitude was evaluated in only the DR group. METHODS: In rural areas, 145 awareness meetings on DM and DR were conducted attended 28 347 individuals. Using systematic random sampling, the data were collected from every 14th individual. In total, 1938 individuals from a rural population were numbered for gaining their responses to the KAP questionnaire. Univariate and multiple regression analyses were performed to identify independent risk factors related to the knowledge of the disease and influence of this knowledge on attitude and practice. RESULTS: Of 1938 individuals, 966 (49.9%) had knowledge of DM and 718 (37.1%) had knowledge of DR. Knowledge about DM was more in women (OR=1.93; 95% CI: 1.55-2.39), in subjects who followed the Christian faith (OR=1.48; 95% CI: 1.07-2.04) and in those who belonged to the upper socioeconomic strata (OR=2.60; 95% CI: 1.84-3.67). The knowledge of DR was significantly higher among subjects who spoke the Malayalam language (OR=3.80; 95% CI: 2.03-7.13), who followed the Christian faith (OR=1.73; 95% CI: 1.27-2.35), and in those who belonged to the upper socioeconomic strata (OR=1.85; 95% CI: 1.32-2.58). Compared with those who had no knowledge of DR (n = 1220), significant percentages of individuals with knowledge (n = 718) had the right attitude - to go for regular eye examinations - (65.9% vs 93.3%) (p<0.0001) ). Regarding practice patterns, only 36.5% of individuals with knowledge about DR believed that if they controlled their blood sugar, they could avoid a visit to an ophthalmologist, compared with 55.5% with no knowledge (p<0.0001). CONCLUSION: The results suggest that we need to propagate aggressive and comprehensive awareness models to educate rural populations on DM and DR.

Diabetic retinopathy in type II diabetics detected by targeted screening versus newly diagnosed in general practice

<p><b>INTRODUCTION</b>The aim of this study was to compare the occurrence of diabetic retinopathy in targeted screening diabetic patients (Group I) with newly diagnosed diabetic patients in general practice (Group II).</p><p><b>MATERIALS AND METHODS</b>This was an observational cross-sectional study. Data were obtained from 25,313 subjects who participated in the diabetic screening camps, and 128 newly diagnosed diabetes who presented to the diabetic retinopathy screening camps in general practice in rural and urban south India. The study variables were collected from all patients who underwent eye examination from the target screening detected diabetics [(n = 173) Group I] and those newly diagnosed in general practice [(n = 128) Group II]. The variations in prevalence of diabetic retinopathy and sight-threatening diabetic retinopathy in Group I and Group II and the factors affecting it were identified.</p><p><b>RESULTS</b>The occurrence of diabetic retinopathy was 6.35% (95% CI, 2.5-9.5) in Group I and 11.71% (95% CI, 5.6-16.4) in Group II. No significant difference was observed on occurrence of diabetic retinopathy, including sightthreatening retinopathy, in rural versus urban population and in Group I versus Group II. Patients diagnosed in general practice (Group II) with systolic blood pressure (BP) >140 were more likely to have retinopathy (P = 0.02).</p><p><b>CONCLUSIONS</b>Diabetic retinopathy including sightthreatening complications was found at the time of diagnosis of diabetes in the targeted screening group as well as in newly diagnosed diabetics in the general practice group.</p>