Every Fourth Diabetic Person In India Suffers From Diabetic Retinopathy

 

Every fourth diabetic person in India suffers from Diabetic Retinopathy and every second Diabetic Retinopathy patient suffers from Sight‑Threatening Diabetic Retinopathy (STDR).

These are the findings of the study Clinical profile and magnitude of diabetic retinopathy: An electronic medical record–driven big data analytics from an eye care network in India conducted by researchers from L V Prasad Eye Institute at Hyderabad, India. 

The study involved analysing the Electronic Medical Records of 263,419 individuals with diabetes presenting to an ophthalmology network spread across four states — Telangana, Andhra Pradesh, Odisha, and Karnataka. It was found that 25 percent of all diabetic patients were suffering from Diabetic Retinopathy. 

Diabetic Retinopathy is an issue close to my heart. It affected my father when he was around 54 years old. He had been suffering from diabetes for more than 15 years then. It was excruciating to see my father — a person who loved to roam, drive and watch TV — slowly lose his sight and become entirely visually impaired. It still hurts when I think of it. 

What is Diabetic Retinopathy?

According to the Mayo Clinic 

"Diabetic Retinopathy (die-uh-BET-ik ret-ih-NOP-uh-thee) is a diabetes complication that affects eyes. It's caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). At first, diabetic Retinopathy might cause no symptoms or only mild vision problems. But it can lead to blindness."

What are the risk factors?

A consortium of 14 specialty eye-care health facilities have been bringing out a series of reports as part of the collaborative study called Spectrum of eye disorders in diabetes(SPEED), including 11,182 people with Type-II Diabetes.

The second report of SPEED was on 'Diabetic retinopathy and risk factors for sight threatening diabetic retinopathy in people with type 2 diabetes in India'. 

In this study, as many as 32 percent of the Diabetic patients were suffering from diabetic Retinopathy, and 19 percent were suffering from STDR. The higher prevalence of Diabetic Retinopathy has been attributed to the study being conducted in tertiary hospitals. 

 

Four major factors associated with the increased risk of Diabetic Retinopathy -

• Poor glycemic control–glycated hemoglobin (HbA1c >10%)

• Requirement of insulin

• History of hypertension 

• Duration of diabetes more than 15 years

 Avoiding Diabetic Retinopathy - Keep Sugar & Blood Pressure under control 

 

The SPEED Report-2 highlights the need to keep sugar levels and Blood Pressure(hypertension) under control to prevent the onset of Diabetic Retinopathy.

 

The report highlights that poor control over sugar levels is linked with a two-fold increase in the chances of acquiring Diabetic Retinopathy and mentions, "Poor blood glucose management and duration of diabetes are the commonly reported risk factors associated with increased risk for DR."

 

The study emphasises the need to keep the Glycated hemoglobin (HBA1C) levels low — at less than 7 percent and maintain a 'near-normal blood pressure to reduce the risk of developing and progression of Diabetic Retinopathy.

 

Keeping hypertension (Blood Pressure) under control is also vital to healthy eyes among people who have diabetes. In the SPEED study, 53 percent of the Diabetic Retinopathy patients were suffering from hypertension. 

 

These measures to prevent Diabetic Retinopathy are of more importance if you have had diabetes from a young age. The prevalence of STDR was found to be the highest among people who have diabetes for more than 15 years. 

 

Stressing on the duration of diabetes as a significant risk factor, the SPEED report mentions, "The duration of diabetes remained the strongest predictor of DR, the odds for retinopathy was over 2 times higher in the 6‑10 years of duration of diabetes, increasing to 3.4 times for a disease duration of 11–15 years and further increased to above 5 times when the duration of diabetes was >15 years."  

 

You CAN avoid Diabetic Retinopathy! 

 

"Up to 98% of DR related visual impairment can be avoided by early screening and prompt management", note three medical experts — Divya Agarwal, Aman Kumar, Atul Kumar — from the Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS).

The AIIMS doctors noted this in their commentary published in the Indian Journal of Ophthalmology along with the findings of the study titled Regional variation in diabetic retinopathy and associated factors in Spectrum of Eye Disease in Diabetes (SPEED) study in India—Report 5.

Calling for the establishment of a "nationwide diabetic retinopathy screening and research network" in India and building a "national registry of diabetic patients", the three AIIMS doctors give the example of Thailand, which managed to reduce the prevalence of Diabetic Retinopathy from 31 percent in 2003 to 5 percent in 2019. This was made possible by the Thailand government through improved, accessible, and comprehensive diabetic care for its people.