Afghani Tayyab, Qureshi Nadeem, Chaudhry Khalid Saeed Ahmad
Department of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan.
J Ayub Med Coll Abbottabad. 2007 Jan-Mar;19(1):16-22.
Prevalence of diabetes and diabetic retinopathy varies in the population considering the background and financial status.
A total of 79,194 people more than 40 years, were screened for diabetes both in the community and eye hospital setting. Initial screening was carried out by urine dipstick followed by random blood sugar examination. A value > or =140 mg/dl of blood sugar was considered positive for diabetes. All the diabetics were then examined for any evidence of diabetic retinopathy through indirect ophthalmoscopy in a dilated pupil by a midlevel ophthalmologist. Health education campaign at public, patient and professional level was also conducted.
The results of screening were analyzed for three distinct groups; rural population, hospital based free patients and hospital based paying patients. The prevalence of diabetes was found to be 9.12%, 10.34% and 18.57% in rural community, poor hospital and affluent hospital groups respectively. The prevalence of diabetic retinopathy in the total screened population in these three subgroups was 1.92%, 2.52% and 4.42% respectively, while this prevalence in the diabetic population was 21.05%, 24.39% and 23.80% respectively. The cost per person screened was $2.6-3.4, while the cost per diabetic identified was $26-28 and the cost per patient of diabetic retinopathy identified was $ 108-135. CONCLUSION; The prevalence of diabetic retinopathy was two times more in the affluent hospital patients as compared to poor hospital patients or rural population. For each known diabetic, there were four previously undiscovered diabetics in the rural population, and two previously undiscovered diabetics in hospital based population.
考虑到背景和经济状况，糖尿病及糖尿病视网膜病变在人群中的患病率有所不同。
对总共79194名40岁以上人群在社区和眼科医院进行糖尿病筛查。初始筛查采用尿试纸法，随后进行随机血糖检测。血糖值≥140mg/dl被视为糖尿病阳性。然后由中级眼科医生在散瞳状态下通过间接检眼镜对所有糖尿病患者检查是否有糖尿病视网膜病变的迹象。还在公众、患者和专业人员层面开展了健康教育活动。
对筛查结果按三个不同组进行分析；农村人口、医院免费患者和医院付费患者。农村社区、贫困医院和富裕医院组的糖尿病患病率分别为9.12%、10.34%和18.57%。这三个亚组中总筛查人群的糖尿病视网膜病变患病率分别为1.92%、2.52%和4.42%，而糖尿病患者中的患病率分别为21.05%、24.39%和23.80%。每人筛查成本为2.6 - 3.4美元，而每名确诊糖尿病患者的成本为26 - 28美元，每名确诊糖尿病视网膜病变患者的成本为108 - 135美元。结论：富裕医院患者的糖尿病视网膜病变患病率比贫困医院患者或农村人口高两倍。在农村人口中，每发现一名已知糖尿病患者，就有四名此前未被发现的糖尿病患者，在医院人群中则有两名此前未被发现得糖尿病患者。
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