Correlates of retinopathy in persons living with type 2 diabetes at a clinic in Zambia

TL;DR

This study found a 25% prevalence of diabetic retinopathy among type 2 diabetes patients in Zambia, with longer diabetes duration being a key risk factor.

Contribution

The study provides new insights into diabetic retinopathy prevalence and risk factors in a Zambian population.

Findings

25% of participants had diabetic retinopathy.

Longer duration of T2DM was significantly associated with retinopathy.

Most participants had uncontrolled blood sugar and did not exercise regularly.

Abstract

diabetes mellitus presents a significant public health challenge globally, with its prevalence projected to rise, particularly in developing countries. Diabetic retinopathy is a common complication of diabetes and a leading cause of blindness among adults. Despite its significance, research on diabetic retinopathy in sub-Saharan Africa, including Zambia, remains limited. This study aimed to determine the prevalence of diabetic retinopathy and identify associated factors among individuals with type 2 diabetes mellitus (T2DM) attending Mahatma Gandhi Clinic in the Livingstone District of the Southern Province of Zambia.

this was a cross-sectional study, involving 48 participants aged 18 years and above, living with T2DM, and enrolled at Mahatma Gandhi Clinic in Livingstone District of Southern Province, Zambia. The primary outcome was diabetic retinopathy, which was classified using the international classification of diabetic retinopathy. Both univariate and bivariate analysis were used to estimate the prevalence of diabetic retinopathy, whereas, logistic regression was used to determine the bio-demographic, social, and clinical variables associated with diabetic retinopathy.

the majority were females (n=37, 77.1%). The median age was 54 years (interquartile range (IQR) 48, 65). The mean Body Mass Index (BMI) was 27.4 (standard deviation (SD), ±6.0). The median duration of living with T2DM was 60 months (IQR, 36,132), with a mean pulse pressure of 9.6 ± 2.8 mmHg and mean glycosylated hemoglobin (HBA1C) of 9.58 ± 2.77%. Fifty percent of the participants had visual problems and hypertension (n=24 each, 50%,). Most participants reported not exercising for at least 30 minutes (n=37, 77.1 %,) and had uncontrolled sugar levels (n=32, 66.7%). Of the 48 participants, 12 (25%) had diabetic retinopathy. Longer duration of T2DM was the only factor significantly associated with diabetic retinopathy on multivariable analysis (AOR: 1.01; 95%Cl 1.00, 1.03, p<0.038).

this study highlights a high prevalence (25%) of diabetic retinopathy among people living with type 2 diabetes mellitus (T2DM) being managed at Mahatma Gandhi Clinic in the Livingstone District of the Southern Province of Zambia. Longer duration of living with T2DM was positively associated with diabetic retinopathy. There is a need to provide routine eye examinations in this population and increase knowledge among clients living with T2DM to reduce the burden of diabetic retinopathy in our setting.

Figures