Cargando…

Retinopathy among young adults with Diabetes Mellitus from a tertiary care setting in Sri Lanka

BACKGROUND: Diabetic retinopathy (DR) is one of the leading causes for complete loss of vision among working-aged adults around the world. The present study aims to evaluate the rate of DR and its risk factors among the adults with young-onset diabetes from a tertiary care setting in Sri Lanka. METH...

Descripción completa

Detalles Bibliográficos
Autores principales: Katulanda, Prasad, Waniganayake, Yasindu C, Ranasinghe, Priyanga, Wijetunga, WM Udai Akalanka, Jayaweera, Mahesh, Wijesinghe, Nishantha P, Sheriff, Rezvi, Matthews, David R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3943575/
https://www.ncbi.nlm.nih.gov/pubmed/24588941
http://dx.doi.org/10.1186/1472-6823-14-20
_version_ 1782306285287374848
author Katulanda, Prasad
Waniganayake, Yasindu C
Ranasinghe, Priyanga
Wijetunga, WM Udai Akalanka
Jayaweera, Mahesh
Wijesinghe, Nishantha P
Sheriff, Rezvi
Matthews, David R
author_facet Katulanda, Prasad
Waniganayake, Yasindu C
Ranasinghe, Priyanga
Wijetunga, WM Udai Akalanka
Jayaweera, Mahesh
Wijesinghe, Nishantha P
Sheriff, Rezvi
Matthews, David R
author_sort Katulanda, Prasad
collection PubMed
description BACKGROUND: Diabetic retinopathy (DR) is one of the leading causes for complete loss of vision among working-aged adults around the world. The present study aims to evaluate the rate of DR and its risk factors among the adults with young-onset diabetes from a tertiary care setting in Sri Lanka. METHODS: A consecutive sample of 1,007 individuals referred from multiple centers, were invited for the study. Ophthalmological evaluation was done, with dilated indirect ophthalmoscopy by an Ophthalmologist. Retinopathy was classified according to the International Clinical DR Disease Severity Scale. An interviewer-administered questionnaire was used to collect socio-demographic and anthropometric details. Seated blood pressure, Fasting Blood Glucose (FBG), HbA1c and urine microalbumin were also measured. Data were analysed using SPSSv14. A binary logistic regression analysis was performed in all patients, with ‘presence of DR’ as the dichotomous dependent variable and other independent covariates. RESULTS: Sample size was 684 (response rate–67.9%), mean age was 37.1 ± 5.9 years and 36.0% were males. Mean duration of diabetes was 5.2 ± 4.0 years. Previous retinal screening had been done in 51.0% by a non-specialist doctor and in 41.5% by a consultant ophthalmologist. Rate of any degree of DR in the study population was 18.1% (Males 16.4%, Females 20.0%; P = NS). In patients with DR, majority had mild Non-Proliferative DR (NPDR) (57.2%), while 32.2% had moderate NPDR, 0.8% had severe NPDR and 9.7% had maculopathy. Mean age, duration of diabetes, systolic (SBP) and diastolic blood pressure (DBP), FBG, HbA1c and urine microalbumin levels were significantly higher amongst the patients with DR. The results of the binary logistic regression indicate that the duration of diabetes (OR:1.24), HbA1c (OR:1.19), age (OR:1.11), urine Microalbumin (OR:1.11) and DBP (OR:1.04) all were significantly associated with DR. CONCLUSIONS: In this large multi center study, nearly one in five adults with young-onset diabetes was found to have retinopathy. Age, duration of diabetes, HbA1C and urine Microalbumin levels were significantly associated with the presence of retinopathy, while HbA1c was also a significant factor determining severity. Nearly 50% of the study population has never undergone retinal screening by an ophthalmologist, highlighting the need for well organized screening programs.
format Online
Article
Text
id pubmed-3943575
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-39435752014-03-06 Retinopathy among young adults with Diabetes Mellitus from a tertiary care setting in Sri Lanka Katulanda, Prasad Waniganayake, Yasindu C Ranasinghe, Priyanga Wijetunga, WM Udai Akalanka Jayaweera, Mahesh Wijesinghe, Nishantha P Sheriff, Rezvi Matthews, David R BMC Endocr Disord Research Article BACKGROUND: Diabetic retinopathy (DR) is one of the leading causes for complete loss of vision among working-aged adults around the world. The present study aims to evaluate the rate of DR and its risk factors among the adults with young-onset diabetes from a tertiary care setting in Sri Lanka. METHODS: A consecutive sample of 1,007 individuals referred from multiple centers, were invited for the study. Ophthalmological evaluation was done, with dilated indirect ophthalmoscopy by an Ophthalmologist. Retinopathy was classified according to the International Clinical DR Disease Severity Scale. An interviewer-administered questionnaire was used to collect socio-demographic and anthropometric details. Seated blood pressure, Fasting Blood Glucose (FBG), HbA1c and urine microalbumin were also measured. Data were analysed using SPSSv14. A binary logistic regression analysis was performed in all patients, with ‘presence of DR’ as the dichotomous dependent variable and other independent covariates. RESULTS: Sample size was 684 (response rate–67.9%), mean age was 37.1 ± 5.9 years and 36.0% were males. Mean duration of diabetes was 5.2 ± 4.0 years. Previous retinal screening had been done in 51.0% by a non-specialist doctor and in 41.5% by a consultant ophthalmologist. Rate of any degree of DR in the study population was 18.1% (Males 16.4%, Females 20.0%; P = NS). In patients with DR, majority had mild Non-Proliferative DR (NPDR) (57.2%), while 32.2% had moderate NPDR, 0.8% had severe NPDR and 9.7% had maculopathy. Mean age, duration of diabetes, systolic (SBP) and diastolic blood pressure (DBP), FBG, HbA1c and urine microalbumin levels were significantly higher amongst the patients with DR. The results of the binary logistic regression indicate that the duration of diabetes (OR:1.24), HbA1c (OR:1.19), age (OR:1.11), urine Microalbumin (OR:1.11) and DBP (OR:1.04) all were significantly associated with DR. CONCLUSIONS: In this large multi center study, nearly one in five adults with young-onset diabetes was found to have retinopathy. Age, duration of diabetes, HbA1C and urine Microalbumin levels were significantly associated with the presence of retinopathy, while HbA1c was also a significant factor determining severity. Nearly 50% of the study population has never undergone retinal screening by an ophthalmologist, highlighting the need for well organized screening programs. BioMed Central 2014-03-04 /pmc/articles/PMC3943575/ /pubmed/24588941 http://dx.doi.org/10.1186/1472-6823-14-20 Text en Copyright © 2014 Katulanda et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Katulanda, Prasad
Waniganayake, Yasindu C
Ranasinghe, Priyanga
Wijetunga, WM Udai Akalanka
Jayaweera, Mahesh
Wijesinghe, Nishantha P
Sheriff, Rezvi
Matthews, David R
Retinopathy among young adults with Diabetes Mellitus from a tertiary care setting in Sri Lanka
title Retinopathy among young adults with Diabetes Mellitus from a tertiary care setting in Sri Lanka
title_full Retinopathy among young adults with Diabetes Mellitus from a tertiary care setting in Sri Lanka
title_fullStr Retinopathy among young adults with Diabetes Mellitus from a tertiary care setting in Sri Lanka
title_full_unstemmed Retinopathy among young adults with Diabetes Mellitus from a tertiary care setting in Sri Lanka
title_short Retinopathy among young adults with Diabetes Mellitus from a tertiary care setting in Sri Lanka
title_sort retinopathy among young adults with diabetes mellitus from a tertiary care setting in sri lanka
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3943575/
https://www.ncbi.nlm.nih.gov/pubmed/24588941
http://dx.doi.org/10.1186/1472-6823-14-20
work_keys_str_mv AT katulandaprasad retinopathyamongyoungadultswithdiabetesmellitusfromatertiarycaresettinginsrilanka
AT waniganayakeyasinduc retinopathyamongyoungadultswithdiabetesmellitusfromatertiarycaresettinginsrilanka
AT ranasinghepriyanga retinopathyamongyoungadultswithdiabetesmellitusfromatertiarycaresettinginsrilanka
AT wijetungawmudaiakalanka retinopathyamongyoungadultswithdiabetesmellitusfromatertiarycaresettinginsrilanka
AT jayaweeramahesh retinopathyamongyoungadultswithdiabetesmellitusfromatertiarycaresettinginsrilanka
AT wijesinghenishanthap retinopathyamongyoungadultswithdiabetesmellitusfromatertiarycaresettinginsrilanka
AT sheriffrezvi retinopathyamongyoungadultswithdiabetesmellitusfromatertiarycaresettinginsrilanka
AT matthewsdavidr retinopathyamongyoungadultswithdiabetesmellitusfromatertiarycaresettinginsrilanka