Incidence of Diabetic Retinopathy and Its Predictors Among Newly Diagnosed Type 1 and Type 2 Diabetic Patients: A Retrospective Follow-up Study at Tertiary Health-care Setting of Ethiopia

Gebiso Roba Debele; Shuma Gosha Kanfe; Adisu Birhanu Weldesenbet; Galana Mamo Ayana; Wakuma Wakene Jifar; Temam Beshir Raru

doi:10.2147/DMSO.S300373

Incidence of Diabetic Retinopathy and Its Predictors Among Newly Diagnosed Type 1 and Type 2 Diabetic Patients: A Retrospective Follow-up Study at Tertiary Health-care Setting of Ethiopia

Diabetes Metab Syndr Obes. 2021 Mar 22:14:1305-1313. doi: 10.2147/DMSO.S300373. eCollection 2021.

Authors

Gebiso Roba Debele¹, Shuma Gosha Kanfe², Adisu Birhanu Weldesenbet³, Galana Mamo Ayana³, Wakuma Wakene Jifar⁴, Temam Beshir Raru³

Affiliations

¹ Department of Public Health, College of Health Sciences, Mettu University, Mettu, Ethiopia.
² Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia.
³ Department of Epidemiology and Biostatistics, Collage of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia.
⁴ Department of Pharmacy, College of Health Sciences, Mettu University, Mettu, Ethiopia.

Abstract

Background: With an increasing number of diabetes patients in developing countries, the burden of diabetes-related blindness is undoubtedly posing a massive challenge to the sustainable health care system due to the cost of care. Despite this fact, to date, most of the epidemiological research on diabetic retinopathy (DR) in eastern Africa, including Ethiopia, has been limited to survey studies. Thus, we determined the incidence of retinopathy and its predictors among diabetic patients in Jimma University Medical Center, Southwest Ethiopia.

Methods: A retrospective follow-up study was conducted on 402 randomly selected diabetic patients of aged ≥15 years. A preliminary reviewed checklist was used to obtain information on the demographics, clinical and physiological attributes. Data were entered using EpiData version 4.6 and analyzed using Stata version 14. All variables at P-values less than 0.2 in bivariable analysis were exported to multivariable analysis. Multivariable accelerated failure time (AFT) regression analyses using Weibull distribution were used to examine the predictors of DR at a 5% level of significance.

Results: Throughout a median follow-up period of 5.9 years, the cumulative incidence of DR was 20.15% (95%CI: 16.50-24.37) and the incidence rate was 36.9 per 1000 person years (PY) (95%CI: 29.7-45.9). Multivariable Weibull AFT regression analyses showed that type two diabetes mellitus (T2DM) (adjusted time ratio (ATR) 0.4095%CI: 0.20-0.78), hypertension (HTN) (ATR 0.54; 95%CI: [0.35, 0.82]), low high density lipoprotein cholesterol (HDL-C) (ATR 0.51; 95%CI: 0.36-0.73), and borderline high total cholesterol (TC) (ATR 0.63; 95%CI: 0.42-0.94) were a predictor of time to DR.

Conclusion: The overall incidence of DR among patients with diabetes mellitus was estimated to be 20.15% and is becoming a public health burden in Ethiopia. Our results indicate that T2DM, HTN, low HDL-C and borderline high TC independently predicts an increased incidence/decreased survival time of retinopathy among diabetes patients. The low HDL-C, HTN, and high TC are modifiable risk factors that should be managed along with diabetes.

Keywords: diabetes mellitus; diabetic retinopathy; incidence; predictors.

Grants and funding

The University of Gondar has covered the costs of data collectors and supervisors per diem. However, the university had no role in the study design, data collections, and analysis, decision to publish, or preparation of the manuscript.