Determinants of diabetic retinopathy among adult and elderly individuals with diabetes

Abstract

BACKGROUND: Diabetic retinopathy is the most prevalent long-term impact of diabetes and the main cause of visual loss and impairment in persons with both type 1 and type 2 diabetes especially among adult and elderly diabetics. However, there are limited studies on the determinants of diabetic retinopathy in the study area. Hence, this study aimed to assess the determinants of diabetic retinopathy among adult and elderly diabetic patients on follow up at Debre Tabor and Felege Hiwot comprehensive specialized Hospitals, Northwest Ethiopia, 2024. METHODS: An institution-based unmatched case-control study design was conducted at Debre Tabor and Felege Hiwot comprehensive specialized hospitals Northwest, Ethiopia from March 30, 2024 to May 29, 2024 using proportional allocation of stratified sampling technique. Diabetic patients with retinopathy were cases in the study and with no retinopathy were controls. Data were collected using a pretested interviewer administered questionnaire, Topcon retinal examination, and a record review. The collected data were entered into Epi Data version 4.6 Software and analyzed using STATA Version 17. Multivariate logistic regression analysis was used to assess the determinants of diabetic retinopathy at 95% confidence interval with P-Value < 0.05. RESULTS: A total of 356 patients (178 cases and 178 controls) were included in the study. The mean age for the cases and the controls were 49.7 (SD: ±14.1) and 44.97 (SD: ±14.67) respectively. Patients with glucometer at home (AOR(Adjusted odds ratio); 0.38, 95%CI; 0.2-0.8), exercise adherence (AOR; 0.4, 95%CI; 0.2-0.9), with systemic complication (AOR; 3.6, 95%CI; 1.5-8.7), health information on diabetic complications(AOR; 0.34, 95%CI; 0.17-0.7), appointments every month (AOR; 0.15, 95%CI; 0.04-0.49),diabetes duration (AOR; 1.12, 95%CI; 1.03-1.18), difficulty of eye examination(AOR; 2.6, 95%CI; 1.2-5.8) and poor blood Glucose control(AOR; 2.1, 95%CI; 1.1-3.9) were significant determinants at p value of 0.05. CONCLUSION AND RECOMMENDATION: Factors such as glucometer at home, exercise, health information on complications, appointments frequency, duration, difficulty of eye examination, blood glucose control and systemic complication status were determinants for diabetic retinopathy. Interventional strategies that promote patient's adherence of glycaemic control and eye examination should be designed and implemented.