Elwali Einas S, Almobarak Ahmed O, Hassan Mona A, Mahmooud Amir A, Awadalla Heitham, Ahmed Mohamed H
Public and Tropical Heath Program, Graduate College, University of Medical Sciences and Technology, Khartoum, Sudan.
Department of Pathology, Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan.
Int J Ophthalmol. 2017 Jun 18;10(6):948-954. doi: 10.18240/ijo.2017.06.18. eCollection 2017.
To assess the frequency and associated risk factors of diabetic retinopathy among Sudanese individuals with diabetes attending Makka Eye complex in Khartoum, Sudan.
The cross sectional hospital based study recruited 316 individuals with diabetes from Makkah Eye Complex Retina Clinic. Standard questionnaire was used to collect demographic data, medical history and life style characteristics. Blood samples were taken to measure HbA1c and lipid profile. Fundus and slit lamp examination were performed for screening of diabetic retinopathy.
Among 316 participants, 187 (59.2%) were males and 129 (40.8%) were females. The mean age of participants was 58.7±10.5y. The overall frequency of retinopathy was 261 (82.6%). The percentages of the total participants with proliferative diabetic retinopathy (PDR) were 126 (39.9%) and non-proliferative diabetic retinopathy (NPDR) were 135 (42.7%). Importantly, duration of diabetes mellitus (DM) (72.2% of more than 10y), being on oral hypoglycaemic drugs (versus insulin), and hypertension were all significant risk factors for diabetic retinopathy (=0.00, 0.01 and 0.00 respectively). Complications of diabetes like diabetic foot (17.7%), history of amputation (6.7%) and clinically significant macular edema (CSME) (47.4%) of the eyes were all significant risk factors (<0.05). Logistic regression analysis showed that duration of diabetes, hypertension and CSME were found to be absolute risk factors (=0.007, 0.003 and 0.000 respectively). Duration of DM of more than 10y have more than double risk (OR=2.8), while having hypertension triples the risk of retinopathy (OR=3.1).
High rates of diabetic retinopathy are noted among individuals with diabetes attending Makkah Eye hospital in capital Khartoum. Urgent strategies are needed to monitor and treat hypertension and optimize diabetes control in individuals with diabetes. More investment in diabetes services is urgently needed.
评估在苏丹喀土穆麦加眼科中心就诊的糖尿病患者中糖尿病视网膜病变的发生率及相关危险因素。
这项基于医院的横断面研究从麦加眼科中心视网膜诊所招募了316名糖尿病患者。使用标准问卷收集人口统计学数据、病史和生活方式特征。采集血样以测量糖化血红蛋白(HbA1c)和血脂谱。进行眼底和裂隙灯检查以筛查糖尿病视网膜病变。
在316名参与者中,187名(59.2%)为男性,129名(40.8%)为女性。参与者的平均年龄为58.7±10.5岁。视网膜病变的总体发生率为261例(82.6%)。增殖性糖尿病视网膜病变(PDR)在所有参与者中的比例为126例(39.9%),非增殖性糖尿病视网膜病变(NPDR)为135例(42.7%)。重要的是,糖尿病病程(72.2%超过10年)、使用口服降糖药(与胰岛素相比)以及高血压均为糖尿病视网膜病变的显著危险因素(分别为P=0.00、0.01和0.00)。糖尿病并发症如糖尿病足(17.7%)、截肢史(6.7%)以及眼部临床显著性黄斑水肿(CSME)(47.4%)均为显著危险因素(P<0.05)。逻辑回归分析显示,糖尿病病程、高血压和CSME被发现是绝对危险因素(分别为P=0.007、0.003和0.000)。糖尿病病程超过10年的风险增加一倍多(比值比[OR]=2.8),而患有高血压会使视网膜病变风险增加两倍(OR=3.1)。
在首都喀土穆的麦加眼科医院就诊的糖尿病患者中,糖尿病视网膜病变的发生率较高。需要采取紧急策略来监测和治疗高血压,并优化糖尿病患者的血糖控制。迫切需要对糖尿病服务进行更多投资。