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Importance of Early Spotting of Diabetic Retinopathy in Type 2 Diabetes Patients by Family Medicine Physicians and Ophthalmologists: A Study in Jordan

Background: Diabetes mellitus is a long-standing progressive disorder. Diabetic retinopathy is the primary cause of blindness among adults suffering from diabetes. Diabetic retinopathy is found to be dependent on the length of the period affected by diabetes, glucose control, blood pressure, and lip...

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Autores principales: Marie, Latifa, Al-Dabbas, Mohammad, Khatatbeh, Ahmed, Al-Mahmood, Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9974016/
https://www.ncbi.nlm.nih.gov/pubmed/36865959
http://dx.doi.org/10.7759/cureus.34342
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author Marie, Latifa
Al-Dabbas, Mohammad
Khatatbeh, Ahmed
Al-Mahmood, Ali
author_facet Marie, Latifa
Al-Dabbas, Mohammad
Khatatbeh, Ahmed
Al-Mahmood, Ali
author_sort Marie, Latifa
collection PubMed
description Background: Diabetes mellitus is a long-standing progressive disorder. Diabetic retinopathy is the primary cause of blindness among adults suffering from diabetes. Diabetic retinopathy is found to be dependent on the length of the period affected by diabetes, glucose control, blood pressure, and lipid profile while age, sex, and type of medical therapy were not found to be risk factors.  Aim: This study attempts to determine the importance of early spotting of diabetic retinopathy in Jordanian type 2 diabetes mellitus (T2DM) subjects by family medicine and ophthalmologist physicians, which will help us achieve better health outcomes.  Methods: Our retrospective investigation recruited 950 working-age subjects, of both sexes and with T2DM at three hospitals in Jordan, from September 2019 to June 2022. Early spotting of diabetic retinopathy was done by family medicine physicians and confirmation was done by ophthalmologists using direct ophthalmoscopy. Evaluation of the fundus by pupillary dilation was performed to assess the degree of diabetic retinopathy, macular edema, and the number of patients with diabetic retinopathy. The level of severity for diabetic retinopathy at confirmation was done using the classification for diabetic retinopathy produced by the American Association of Ophthalmology (AAO). Continuous parameters and independent t-tests were used to assess the average discrepancy in the degree of retinopathy among subjects. Categorical parameters were mentioned in numbers and percentages and chi-square tests were done to determine discrepancies in proportion among patients.   Results: Early spotting of diabetic retinopathy was recorded by family medicine physicians in 150 (15.8%) of 950 patients with T2DM of whom 56.7% (85/150) were women with an average age of 44 years. Of these 150 subjects with T2DM, who were presumed to have diabetic retinopathy, ophthalmologists diagnosed diabetic retinopathy in 35 patients (35/150; 23.3%). Of these, 33 (94.3%) had non-proliferative diabetic retinopathy and two (5.7%) had proliferative diabetic retinopathy. Of the 33 patients with non-proliferative diabetic retinopathy, 10 had mild non-proliferative diabetic retinopathy, 17 had moderate non-proliferative diabetic retinopathy, and six had severe non-proliferative diabetic retinopathy. Subjects aged more than 28 years had a 2.5 times increased risk of experiencing diabetic retinopathy. Awareness and lack of awareness values differed significantly (316 (33.3%), 634 (66.7%); P<0.05, respectively).  Conclusions: Early spotting of diabetic retinopathy by family medicine physicians shortens the delay of diagnosis confirmation by ophthalmologists.
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spelling pubmed-99740162023-03-01 Importance of Early Spotting of Diabetic Retinopathy in Type 2 Diabetes Patients by Family Medicine Physicians and Ophthalmologists: A Study in Jordan Marie, Latifa Al-Dabbas, Mohammad Khatatbeh, Ahmed Al-Mahmood, Ali Cureus Endocrinology/Diabetes/Metabolism Background: Diabetes mellitus is a long-standing progressive disorder. Diabetic retinopathy is the primary cause of blindness among adults suffering from diabetes. Diabetic retinopathy is found to be dependent on the length of the period affected by diabetes, glucose control, blood pressure, and lipid profile while age, sex, and type of medical therapy were not found to be risk factors.  Aim: This study attempts to determine the importance of early spotting of diabetic retinopathy in Jordanian type 2 diabetes mellitus (T2DM) subjects by family medicine and ophthalmologist physicians, which will help us achieve better health outcomes.  Methods: Our retrospective investigation recruited 950 working-age subjects, of both sexes and with T2DM at three hospitals in Jordan, from September 2019 to June 2022. Early spotting of diabetic retinopathy was done by family medicine physicians and confirmation was done by ophthalmologists using direct ophthalmoscopy. Evaluation of the fundus by pupillary dilation was performed to assess the degree of diabetic retinopathy, macular edema, and the number of patients with diabetic retinopathy. The level of severity for diabetic retinopathy at confirmation was done using the classification for diabetic retinopathy produced by the American Association of Ophthalmology (AAO). Continuous parameters and independent t-tests were used to assess the average discrepancy in the degree of retinopathy among subjects. Categorical parameters were mentioned in numbers and percentages and chi-square tests were done to determine discrepancies in proportion among patients.   Results: Early spotting of diabetic retinopathy was recorded by family medicine physicians in 150 (15.8%) of 950 patients with T2DM of whom 56.7% (85/150) were women with an average age of 44 years. Of these 150 subjects with T2DM, who were presumed to have diabetic retinopathy, ophthalmologists diagnosed diabetic retinopathy in 35 patients (35/150; 23.3%). Of these, 33 (94.3%) had non-proliferative diabetic retinopathy and two (5.7%) had proliferative diabetic retinopathy. Of the 33 patients with non-proliferative diabetic retinopathy, 10 had mild non-proliferative diabetic retinopathy, 17 had moderate non-proliferative diabetic retinopathy, and six had severe non-proliferative diabetic retinopathy. Subjects aged more than 28 years had a 2.5 times increased risk of experiencing diabetic retinopathy. Awareness and lack of awareness values differed significantly (316 (33.3%), 634 (66.7%); P<0.05, respectively).  Conclusions: Early spotting of diabetic retinopathy by family medicine physicians shortens the delay of diagnosis confirmation by ophthalmologists. Cureus 2023-01-29 /pmc/articles/PMC9974016/ /pubmed/36865959 http://dx.doi.org/10.7759/cureus.34342 Text en Copyright © 2023, Marie et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Endocrinology/Diabetes/Metabolism
Marie, Latifa
Al-Dabbas, Mohammad
Khatatbeh, Ahmed
Al-Mahmood, Ali
Importance of Early Spotting of Diabetic Retinopathy in Type 2 Diabetes Patients by Family Medicine Physicians and Ophthalmologists: A Study in Jordan
title Importance of Early Spotting of Diabetic Retinopathy in Type 2 Diabetes Patients by Family Medicine Physicians and Ophthalmologists: A Study in Jordan
title_full Importance of Early Spotting of Diabetic Retinopathy in Type 2 Diabetes Patients by Family Medicine Physicians and Ophthalmologists: A Study in Jordan
title_fullStr Importance of Early Spotting of Diabetic Retinopathy in Type 2 Diabetes Patients by Family Medicine Physicians and Ophthalmologists: A Study in Jordan
title_full_unstemmed Importance of Early Spotting of Diabetic Retinopathy in Type 2 Diabetes Patients by Family Medicine Physicians and Ophthalmologists: A Study in Jordan
title_short Importance of Early Spotting of Diabetic Retinopathy in Type 2 Diabetes Patients by Family Medicine Physicians and Ophthalmologists: A Study in Jordan
title_sort importance of early spotting of diabetic retinopathy in type 2 diabetes patients by family medicine physicians and ophthalmologists: a study in jordan
topic Endocrinology/Diabetes/Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9974016/
https://www.ncbi.nlm.nih.gov/pubmed/36865959
http://dx.doi.org/10.7759/cureus.34342
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