Awareness of diabetic retinopathy among people with diabetes in Jeddah, Saudi Arabia

Diabetic retinopathy: Knowledge, awareness, and practices in primary-care centers in the Kingdom of Bahrain

Background

With the growing incidence of diabetic-related complications such as retinopathy and the well-understood role of screening and telemedicine around the world in preventing and managing this potentially blinding disease, there comes the importance of awareness toward this silent eye condition. Awareness ideally should be raised both from the patients' and physicians' perspectives. This study aims to assess the awareness of primary care physicians (PCPs) towards diabetic retinopathy (DR) and its management.

Materials and Methods

A survey considering professional background, knowledge, and practices was distributed electronically to all PCPs in the Kingdom of Bahrain and analyzed using SPSS Vs 21.

Results

A total of 83 physicians completed the survey; 81.9% were female and 96.4% were Bahraini. More than 60% of them accurately knew screening guidelines for type 1 and 2 DR. Of the total, 72.5% would refer patients to the ophthalmologist even if asymptomatic, and 97.6% correctly stated that a dilated eye exam is the method of choice most efficient for assessing DR. Nearly 60% knew about the current treatment modalities for DR and 91.3% knew about the presence of a national screening program in the Kingdom.

Conclusion

The overall knowledge of DR was good with some potential gaps in information about screening. PCPs could benefit from regular refresher courses for more precise practices on screening and referral of retinopathy.

The Evaluation of Diabetic Patients' Awareness of Diabetic Retinopathy and Its Complications in the Western Region of Saudi Arabia

Background Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia. Globally, 382 million people have diabetes mellitus, and 90% of these patients suffer from type 2 diabetes. Saudi Arabia has the second-highest prevalence of diabetes among all Middle Eastern countries. Diabetic retinopathy (DR) is a significant complication of diabetes; early detection and proper intervention are important for its management and prognosis. Aim This study aims to assess the awareness of diabetic patients of diabetic retinopathy symptoms and complications in the western region of Saudi Arabia. Methods This is a cross-sectional study in which a convenience sampling technique was implemented for collecting data from all patients who fulfilled the inclusion criteria within the timeframe between February 2022 and October 2022 among diabetic patients at the National Guard Health Affairs in the western region. We included both type 1 and type 2 diabetic participants who are older than 18 years of age and have at least one visit to any outpatient ophthalmology clinic. Results This study involved 259 participants. The mean age of the participants is 46.69 (standard deviation {SD}: 15.59). Type 2 was more prevalent among the applicants (58.3%). A total of 242 (93%) participants were aware that diabetes could affect their eyes. Surprisingly, 130 (50.2%) do not know about diabetic retinopathy therapy options. The most significant obstacle to being examined early for ophthalmological diseases among diabetic patients was the deficient knowledge of diabetic retinopathy. Also, a significant statistical relationship was found between the year of diagnosis and the level of awareness regarding eye complications. Conclusion Despite the high level of awareness of diabetic retinopathy among diabetic patients shown in our study, it did not correspond to a high level of self-awareness on the importance of preventive measures such as annual diabetic retinopathy screening.

Awareness of Diabetic Retinopathy Among Patients With Type 2 Diabetes Mellitus in Primary Healthcare Centers in Madinah, Saudi Arabia: A Cross-Sectional Study

Background The prevalence of diabetes mellitus (DM) in Saudi Arabia is among the highest in the Middle East and North Africa (MENA) regions. Various complications of DM can cause problems in the long term. One of the most prevalent microvascular problems and the primary cause of blindness is diabetic retinopathy (DR), and a significant proportion of the population with diabetes eventually develop diabetes retinopathy. Recognizing and understanding DR may be crucial for patients in identifying and averting this complication.  Objectives The objective of this atudy is to assess the awareness of DR among patients with type 2 DM at primary healthcare centers in Madinah, Saudi Arabia.  Methods This cross-sectional study involved a survey of patients with diabetes who attended Madinah primary care clinics between August and September 2023. The study was conducted in Madinah, Saudi Arabia, from May to November 2023.  Results A total of 240 patients participated with a median age of 49.7 years and a gender distribution of 121 (50.4%) men. Overall, less than half of patients had a fair level of knowledge (47.1%) and a good level of knowledge (42.1%) about DR, whereas 10.8% had poor knowledge. Physicians were the primary source of information for patients, followed by the internet, family, and friends. Higher levels of education, diabetes that had been present for a longer period, and regular eye exams were associated with better understanding. This study emphasizes the importance of improving patient knowledge and awareness of DR.  Conclusions We observed a high level of awareness of DR among participants. Furthermore, higher awareness was associated with longer disease duration and compliance with diabetes treatment.

Public awareness about glaucoma, cataract, and diabetic retinopathy in Saudi Arabia: a systematic review and meta-analysis

PURPOSE

To identify the public level of knowledge about the common ophthalmological conditions in Saudi Arabia.

METHODS

We searched Medline, Embase, and CENTRAL for relevant literature. We included questionnaire-based cross-sectional studies performed in Saudi Arabia assessing the public awareness and attitude about general knowledge, causes/risk factors, signs/symptoms, disabilities/consequences, and relieving/management measures of the common ophthalmological conditions including glaucoma, cataract, and diabetic retinopathy (DR). The meta-analysis was performed on outcomes reported in ≥ 2 studies utilizing the random-effects model. Quality assessment was done using the Appraisal tool for Cross-Sectional Studies (AXIS) tool.

RESULTS

Twenty-eight studies were deemed eligible for inclusion in this review. A total of 72 questions were reported in ≥ 2 studies and were included in the meta-analysis. The total number of participants was 14,408. The meta-analysis estimated that 57.63% (95% confidence interval (CI) 56.87-60.07%), 69.90% (95% CI 67.02-76.07%), and 68.65% (95% CI 65.94-71.23%) of the Saudi public have you ever heard or read about glaucoma, cataract, and DR, respectively. Of the public surveyed in the included studies, 43.68% (95% CI 41.54-45.85%), 55.43% (95% CI 54.03-56.82%), and 63% (95% CI 60.8-65.1%) believed that glaucoma, cataract, and DR could be treated.

CONCLUSION

This systematic review showed that the level of knowledge among the Saudi population about the common ophthalmological conditions was the highest with respect to cataract, followed by DR and glaucoma. The areas of unsatisfactory level of awareness about the common ophthalmological conditions included risk factors, signs/symptoms, complications, and management options. These areas need to be addressed appropriately by future educational interventions.

Diabetic Retinopathy Screening Using Non-Mydriatic Fundus Camera in Primary Health Care Settings - A Multicenter Study from Saudi Arabia

Background

Screening of diabetic retinopathy (DR) using the current digital imaging facilities in a primary health care setting is still in its early stages in Saudi Arabia. This study aims to reduce the risk of vision impairment and blindness among known diabetic people through early identification by general practitioners (GP) in a primary health care setting in Saudi Arabia. The objective of this study was to evaluate the accuracy of diabetic retinopathy (DR) detection by general practitioners (GPs) by comparing the agreement of DR assessment between GPs and ophthalmologists' assessment as a gold standard.

Methods

A hospital-based, six-month cross-sectional study was conducted, and the participants were type 2 diabetic adults from the diabetic registries of seven rural PHCs, in Saudi Arabia. After medical examination, the participants were then evaluated by fundus photography using a non-mydriatic fundus camera without medication for mydriasis. Presence or absence of DR was graded by the trained GPs in the PHCs and then compared with the grading of an ophthalmologist which was taken as a reference or a gold standard.

Results

A total of 899 diabetic patients were included, and the mean age of the patients was 64.89 ± 11.01 years. The evaluation by the GPs had a sensitivity of 80.69 [95% CI 74.8-85.4]; specificity of 92.23 [88.7-96.3]; positive predictive value, 74.1 [70.4-77.0]; negative predictive value, 73.34 [70.6-77.9]; and an accuracy of 84.57 [81.8-89.88]. For the consensus of agreement the adjusted kappa coefficient was from 0.74 to 0.92 for the DR.

Conclusion

This study demonstrates that trained GPs in rural health centers are able to provide reliable detection results of DR from fundus photographs. The study highlights the need for early DR screening programs in the rural areas of Saudi Arabia to facilitate early identification of the condition and to lessen impact of blindness due to diabetes.

Patient and health care provider knowledge of diabetes and diabetic microvascular complications: a comprehensive literature review

Diabetic retinopathy, neuropathy, and nephropathy occur in more than 50% of people with diabetes, contributing substantially to morbidity and mortality. Patient understanding of these microvascular complications is essential to ensure early recognition and treatment of these sequalae as well as associated symptoms, yet little is known about patient knowledge of microvascular sequalae. In this comprehensive literature review, we provide an overview of existing knowledge regarding patient knowledge of diabetes, retinopathy, neuropathy, and nephropathy. We also discuss health care provider's knowledge of these sequalae given that patients and providers must work together to achieve optimal care. We evaluated 281 articles on patient and provider knowledge of diabetic retinopathy, neuropathy, and nephropathy as well as predictors of improved knowledge and screening practices. Results demonstrated that patient and provider knowledge of microvascular sequalae varied widely between studies, which may reflect sociocultural or methodologic differences. Knowledge assessment instruments varied between studies with limited validation data and few studies controlled for confounding. Generally, improved patient knowledge was associated with greater formal education, longer diabetes duration, and higher socioeconomic status. Fewer studies examined provider knowledge of sequalae, yet these studies identified multiple misconceptions regarding appropriate screening practices for microvascular complications and the need to screen patients who are asymptomatic. Further investigations are needed that use well validated measures, control for confounding, and include diverse populations. Such studies will allow identification of patients and providers who would benefit from interventions to improve knowledge of microvascular complications and, ultimately, improve patient outcomes.

Reasons for the Late Presentation of Diabetic Retinopathy in Saudi Arabia: A Survey of Patients Who Presented with Advanced Proliferative Diabetic Retinopathy to a Tertiary Eye Hospital

Purpose

This study aimed to understand the barriers that contribute to diagnostic and therapeutic delays in patients with advanced proliferative diabetic retinopathy (PDR).

Patients and Methods

This cross-sectional study targeted patients with advanced PDR who never received any ocular intervention at King Khaled Eye Specialist Hospital in Saudi Arabia. An Arabic-language questionnaire was used to interview the participants over a period of 6 months. The questionnaire comprised sociodemographic questions followed by several sections to assess the causes of delay in diagnosis and management. Variables were analyzed descriptively and reported as numbers and percentages using SPSS 22.

Results

A total of 338 patients were included in the study. Most patients were older than 50 years (60.4%), and decreased vision was the main complaint at presentation (81%). Vitreous hemorrhage was the most common diagnosis (46%). Patients' lack of knowledge about the importance of DR screening programs and problems with healthcare system screenings were the most frequent causes of delay in diabetic retinopathy (DR) diagnosis and management.

Conclusion

DR is still a major cause of permanent blindness that is treatable with regular follow-up and timely management. Even though DR screening and treatment in Saudi Arabia have improved drastically over the last years, socioeconomic and health system factors remain barriers to the improvement of outcomes of DR.

Awareness Regarding Diabetic Retinopathy Among Adult Diabetic Patients in Al Qunfudah District

Background Diabetes mellitus is a major public health problem worldwide. Diabetic patients may suffer many complications including diabetic retinopathy, which can lead to blindness if left undiagnosed and untreated. Methodology A cross-sectional analytical study was conducted among a sample of 251 adult diabetic patients in the Al Qunfudah district. A self-administrated questionnaire was used for data collection and consisted of the following three sections: sociodemographic data, diabetes mellitus, and diabetic retinopathy-related data. Results Out of the 251 participants, 68.5% recognized that diabetes mellitus can cause eye disorders, and 72.5% of the participants knew that regular eye examinations are recommended for diabetic patients. Adequate knowledge score was observed among diabetic patients aged 25-49 years (52.6%), with a university education (53.5%), with a history of diabetes for 10 years and more (60.5%), those on insulin therapy (55.3%), those adherent to their regular treatment (92.1%), and those getting their information from doctors (73.7%). Conclusions Diabetic patients had average knowledge about diabetic retinopathy but little awareness regarding the frequency of regular eye examinations and the physicians who should conduct them. Intensive health education concerning diabetic retinopathy should be conducted for diabetic patients and their caregivers to improve their perception and compliance with eye care and prevent visual damage in the Al Qunfudhah district.

Diabetic Retinopathy and Eye Screening: Diabetic Patients Standpoint, Their Practice, and Barriers; A Cross-Sectional Study

Diabetes mellites (DM) is one of the most common systemic disorders in Saudi Arabia and worldwide. Diabetic retinopathy (DR) is a potentially blinding ophthalmic consequence of uncontrolled DM. The early detection of DR leads to an earlier intervention, which might be sight-saving. Our aim in this cross-sectional study is to assess patients' knowledge and practices regarding DR, and to detect the barriers for eye screening and receiving a check-up from an ophthalmologist. The study included 386 diabetic patients. One hundred and thirty-one patients (33.9%) had T1DM and 188 (48.7%) had T2DM. Most of the diabetic patients (73.3%) know that they must have an eye check-up regardless of their blood sugar level. DM was agreed to affect the retina in 80.3% of the patients, 56% of patients agree that DM complications are always symptomatic, and 84.5% know that DM could affect their eyes. The fact that blindness is a complication of diabetic retinopathy was known by 65% of the diabetic patients. A better knowledge was detected among patients older than 50 years of age (54.9%) compared to those aged less than 35 years (40.9%), which was statistically significant (p = 0.030). Additionally, 61.2% of diabetic patients who were university graduates had a significantly better knowledge in comparison to 33.3% of illiterate patients (p = 0.006). Considering the barriers to not getting one's eyes screened earlier, a lack of knowledge was reported by 38.3% of the patients, followed by lack of access to eye care (24.4%). In conclusion, there is a remarkable increase in the awareness of DR among the Saudi population. This awareness might lead to an earlier detection and management of DR.

Assessment of Diabetic Patients' Adherence to Diabetic Retinopathy Screening and the Influencing Factors in Al-Ahsa, Saudi Arabia

Background

Diabetic retinopathy (DR) is one of the diabetic complications that leads to the loss of vision. Most diabetic patients will have DR that is varying in its severity under the effect of many factors such as type of diabetes, duration of diabetes, and poor glycemic control. This study aimed to assess the level of adherence of diabetic patients to diabetic retinopathy screening (DRS) and to identify the influencing factors of adherence among diabetic patients in Al Ahsa, Saudi Arabia.

Methods

A cross-sectional study was conducted via a self-administered questionnaire among diabetic patients who were attending the primary health-care centers in Al Ahsa, Saudi Arabia, from July to August 2021. This questionnaire included five sections: sociodemographic data, diabetic profile, assessment of the knowledge, attitude toward DRS, and barriers to DRS.

Results

A total of 397 diabetic patients were involved in the study. Diabetic ocular complications were reported among 35.3% of the patients. The most commonly reported diabetic eye complication was cataract (37.1%; 52) followed by retinopathy (36.4%). Among the participants, 32.2% had a good awareness level regarding DR. In addition, 46.9% of diabetic patients have DRS. The most reported barriers were having no visual or eye problems, difficulty getting an appointment, and the cost and lack of information about the screening procedure (50.9%, 50.1%, 42.1%, and 39.8%, respectively). 

Conclusion

Improvement of patients’ knowledge is a significant step to enhancing adherence to DRS. The availability of screening programs and well-established ophthalmology clinics in primary healthcare centers in addition to trained physicians will help to overcome the barriers of DRS.

Awareness of Diabetic Retinopathy Among Patients With Type 2 Diabetes Attending the Outpatient Clinic in the General Hospital in Rabigh, Saudi Arabia: A Cross-Sectional Study

Introduction: Diabetic retinopathy (DR) is a common microvascular complication of type 2 diabetes (T2D) and a major cause of blindness. DR awareness is important for early identification and management in patients with T2D. This study aimed to estimate the level of awareness of DR and its risk factors among patients with T2D in Saudi Arabia.

Methods: We conducted a cross-sectional study to analyze data collected from 291 patients with T2D attending outpatient clinics in the General Hospital in Rabigh during 2020-2021. We collected demographic information and level of awareness about T2D and DR.

Results: Among 291 patients with T2D, 42.3% had T2D for more than five years, and 37.8% had T2D for two to five years. In our study population, 32.3% of participants obtained high school education, and 42.3% had moderate income. Over half of respondents (56.4%) had their last eye exam within the past year, and 68.4% of participants believed high blood glucose levels might cause vision problems. The mean ± standard deviation of the DR awareness score was 7.23 ± 2.74. Most participants had moderate level of awareness (39.5% of participants), 31.6% had good level of awareness, and 28.9% had poor level of awareness about T2D and DR. Participants without DR or who had DR for less than two years and those who had their eyes checked by a doctor last year had a significantly higher DR awareness level. 

Conclusion: We asked patients with T2D to assess their level of DR awareness. Most patients had moderate awareness levels, indicating a need for improved awareness of T2D complication on retina and treatment options. Patients should also be motivated for retinal screening to reduce the risk of visual complications. Furthermore, DR screening programs should not be limited to eye care centers. Improved awareness and access to screening programs will help patients and their healthcare providers achieve optimal outcomes in prevention of DR.

Awareness and knowledge of diabetic retinopathy in diabetic patients at a General Hospital in Northwest Ethiopia

Objective

Diabetic retinopathy is an evident complication of diabetes on eye and contributes for significant portion of blindness worldwide. In Ethiopia, data are lacking on awareness and knowledge of diabetic retinopathy in diabetic patients. This study desired to assess knowledge of diabetic retinopathy and it is relating factors among diabetic patients attending at a General Hospital in Ethiopia.

Methods

We have interviewed 306 diabetic patients who were attending at Debre Tabor General Hospital. Binary logistic regression model was used to recognize associated factors to good knowledge of diabetic retinopathy. Adjusted odds ratio was used to show the power of association. A p-value of less than 0.05 was set to determine its statistical significance.

Result

The diabetic patients had a median age of 45 (range = 30) years. From the total diabetic patients, 242 (79.10%) knew that diabetes could affect the eye and 81 (26.50%) were aware of diabetic retinopathy. From those who were informed of diabetic retinopathy, 32 (39.50%) (95% confidence interval = 27.90-51.20) had good knowledge of diabetic retinopathy. High educational status (adjusted odds ratio = 4.08, 95% confidence interval = 1.00-16.50) and non-government employee (adjusted odds ratio = 0.19, 95% confidence interval = 0.05-0.70) were significantly associated with good knowledge of diabetic retinopathy. Physicians and eye doctors were the most frequent source of information for the awareness of diabetic retinopathy.

Conclusion

From the total diabetic patients recruited in the study, 39.5% of them obtained information about diabetic retinopathy and the overall knowledge was poor among them. Knowledge of diabetes can affect the eye and it causes blindness was good among majority of the participants. Higher educational status and being a non-government employee were determined to be important predisposing factors of good knowledge. It is also better to involve diabetic educators and counselors in educating diabetic patients on the serious complication of diabetes on eye.

Knowledge, Attitudes, and Practices towards Diabetic Retinopathy among Primary Care Physicians of Saudi Arabia: A Multicenter Cross-Sectional Study

Primary care physicians play a vital role in preventing the progression of diabetic retinopathy (DR) from the initial stages to the late stages. This questionnaire-based analytical cross-sectional study was carried out to assess the knowledge, attitude, practices, and their correlation among 274 randomly selected primary care physicians in Saudi Arabia. Among the studied population, high knowledge, attitudes, and practice scores were observed in 21.5%, 15%, and 29.2% of the physicians, respectively. The mean knowledge score was significantly higher among the age group of less than 30 years (p = 0.031) and the female gender (p = 0.012). The attitude scores were significantly higher among the Saudi physicians (p = 0.027) and those with PHC work experience of less than five years (p < 0.001). Regarding the practices, a significant association was found among the age group of less than 30 years (p = 0.019) and Saudi physicians (p = 0.003). There was a significant positive correlation between knowledge (correlation coefficient (r) = 0.739, p < 0.001) and attitude (r = 0.479, p = 0.007) with the practice scores. It is recommended that targeted continuous medical education, workshops, and seminars are conducted on the prevention and care of DR among primary care physicians. Furthermore, an exploratory multicenter study that involves primary care physicians belonging to all ministries and private sectors is warranted.

Awareness and knowledge about glaucoma among patients visiting the screening clinic in Jeddah Eye Hospital, Saudi Arabia

AIM

To explore levels and determinants of awareness and knowledge about glaucoma among patients.

METHODS

This was a cross-sectional study that included adult patients from October to the end of December 2018. A semi-structured questionnaire was designed by the researchers to measure the levels of awareness and knowledge about 18 basic information about glaucoma. The sheet was divided into 4 domains: types of glaucoma, risk factors, clinical features, and management. A knowledge score (KS, range=0-18) was calculated, with higher scores indicating higher levels.

RESULTS

A total of 383 patients responded to the questionnaire, 61.9% males, mean±SD age was 38.5±12.94 years old, and 61.6% had a university degree or higher. Of them, 6.3% and 23.2% reported personal and family history of glaucoma, respectively. The most frequently reported source of information about glaucoma was another person with glaucoma (28.2%), followed by physicians (24.8%) and TV (19.6%). Knowledge by item ranged from 3.1% to 82.5% correctness rate, while KS showed mean=5.91 and median=5; and reliability testing of the knowledge scale showed Cronbach's alpha=0.782. Higher KS were found among respondents with higher educational level (P=0.036), diabetes history (P=0.025), and personal (P<0.001) and family (P<0.001) history of glaucoma.

CONCLUSION

This study reveals low awareness and knowledge levels about glaucoma among the attendees of a local eye care hospital, where several misconceptions about disease risk factors, clinical features, and management are identified.

Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in Qassim, Saudi Arabia

Introduction:

Diabetic retinopathy (DR) is a well-known complication of diabetes mellitus (DM) and a major cause of vision loss. Increased awareness of DR is crucial for the prevention and early diagnosis of the disease and preservation of vision. The objective of this study is to assess the level of DR awareness in the Qassim region among type 2 diabetic patients.

Materials and Methods:

A cross-sectional study was conducted among patients who visited diabetic clinics between January and March 2019 in the Qassim region, Saudi Arabia. This study used structured questionnaires to assess awareness and knowledge of DR. The patients were considered to have a good level of DR awareness if they answered more than 60% of the questions correctly.

Results:

A total of 307 patients with type 2 DM, 201 males (65.5%) and 106 females (34.5%), participated in the current study. The results revealed that 63.5% of the participating patients involved in this study had good knowledge about DR; 86% of the patients had knowledge about the correlation between retinopathy and DM, and 89.9% believed that DR can be prevented by good control of diabetes.

Conclusion:

The study showed that about two-thirds of the participants were aware of DR, and most of them had knowledge about the relationship between retinopathy and DM. Younger patients and the group with a higher level of education were found to be more aware of DR. Awareness of DR should be correlated with behavioral practices to improve a patient's compliance in attending annual eye examinations.

Diabetic retinopathy screening barriers among Palestinian primary health care patients: a qualitative study

PURPOSE

Diabetic Retinopathy (DR) screening among Palestinian diabetic patients is limited. To improve the care of our patients, we explored the barriers to DR screening with a qualitative study.

METHODS

Three focus groups were conducted in the northern West Bank. Patients noncompliant with DR screening were recruited from Primary Health Care clinics. Questions were adapted from similar published studies. Informed consent was obtained and group discussions were audio recorded, transcribed, and analyzed for themes by three researchers.

RESULTS

Most patients reported financial barriers including the costs of the exam and additional treatments, and transportation to the referral clinic. System related issues were the difficulty of getting appointments and long wait times due to inadequate numbers of ophthalmologists or screening facilities, and physicians failing to recommend screening. Personal concerns related to patients having other priorities, fears about the results, and the negative experiences of family members. Finally, cultural aspects included the stigma of wearing glasses and not doing a test for a condition without symptoms.

CONCLUSIONS

Barriers to completing retinopathy screening are multidimensional with financial, personal, educational, health system, and cultural factors. These should be taken into consideration by policy makers in order to increase the uptake and quality of service.

Knowledge, Attitude, and Practices (KAP) of Diabetics Towards Diabetes and Diabetic Retinopathy in Riyadh, Saudi Arabia: Cross-Sectional Study

BACKGROUND

Diabetes mellitus (DM) and its complication present a major morbidity burden among Saudi population. Awareness and proper knowledge of this highly prevalent disease is crucial to enhance early detection and proper intervention. Therefore, the main aim of this study was to identify the knowledge, attitude, and practices (KAP) of diabetic patients towards diabetes and diabetic retinopathy in Riyadh, Saudi Arabia.

METHODS

This cross-sectional study was conducted in 50 randomly selected primary care centers and two university hospitals in Riyadh, Saudi Arabia, between May and December 2018. Diabetic patients ≥18 years old were enrolled in the study. A validated KAP-45 questionnaire was used to assess the KAP levels of diabetics towards diabetes and diabetic retinopathy.

RESULTS

A total of 313 participants were enrolled in the study. The majority were males 168 (59.8%). The median age was 49 ±24, and the median duration of diabetes was 8 ±11 years. The average knowledge score for diabetes was 10 (good). While the average knowledge score for diabetic retinopathy was 4.5 (suboptimal). The average attitude scores for both diabetes and diabetic retinopathy were 0 and 2 (suboptimal), respectively. The average practice score for diabetes was 5 (good) while it was 3 (low) for diabetic retinopathy. The most common barrier to comply with regular follow-up was inadequate knowledge about the importance of periodic eye exam 47.1% (107). Patients with low socio-economic status had a significantly poor knowledge regarding diabetes (P<0.0001) and diabetic retinopathy (P<0.015), respectively. However, patients with low educational level had a significantly poor knowledge (p<0.0001) and poor practice regarding diabetes (P<0.013), respectively.

CONCLUSION

It is important to improve education and awareness of DM and diabetic retinopathy among diabetics, as it's essential for controlling the disease and reducing its complications, by improving patient compliance to treatment and follow-up.

Awareness of diabetic retinopathy among Saudis with diabetes type 2 in Riyadh city

Objective:

To assess awareness of diabetic retinopathy (DR) for Saudis with diabetes mellitus (DM) type 2 in Riyadh City.

Methods:

A cross-sectional study that used self-administered questionnaires conducted in primary healthcare centers in Riyadh City between October and December 2019.

Results:

There were 267 Saudi participants with diabetes mellitus type 2 visiting primary healthcare clinics. (52.4%) were aged 40 years or above at time of diagnosis with diabetes. (73%) had diabetes for at least 5 years. Most of the participants have a good blood glucose control and they do home measurements. In regard to DR, (64.4%) of participants had no subjective or objective indicators of retinopathy, and (70%) had visited ophthalmology clinics. Majority of the participants were advised about DR or referred to an ophthalmologist by their primary physician, with the percentages being (64.8%) and (59.6%), respectively. Regarding other risk factors of DR, (19.5%) had a family history of DR, (23.2%) of participant are smokers and (41.6%) were hypertensives. Majority of the participants were aware about all the aspects of DR, its consequences, and appropriate management except the laser therapy. In terms of area of living and education respondents, who lived in the center of Riyadh City and the secondary level or less educated participants had the lowest level of education.

Conclusions:

Awareness of DR is acceptable but should not lead this information to reduced awareness and educational programs. Outreach researchers' efforts should cover other directions instead awareness of DR.

Knowledge, attitudes, and practices regarding diabetic retinopathy among primary health care physicians in Al-Hasa, Saudi Arabia

Background

Diabetic retinopathy (DR) has been shown to be the third most observed cause of visual loss in Saudi Arabia. In the Al-Hasa region in particular, the prevalence of DR has been shown to be 30%. Primary health centre (PHC) physicians play a central role in the early detection and prevention of DR. The aim of this study was to evaluate the knowledge, attitudes, and practices regarding DR of PHC physicians in Al-Hasa, Saudi Arabia.

Methods

A cross-sectional descriptive study was conducted at PHCs in Al-Hasa, Saudi Arabia. A self-administered questionnaire was provided to every participant along with a consent form. Out of 71 centres in the region, 63 were included in this study. The questionnaire consisted of three sections and a total of 18 questions. Statistical analysis was carried out using the Statistical Package for the Social Sciences version 21 software program (IBM Corp., Armonk, NY, USA).

Results

One hundred forty-one of 209 physicians completed the questionnaire for a response rate of 67%. The mean of overall knowledge score for all participants was 2.6 ± 1.16 points out of four points. Only 34 (24.1%) of the participants correctly referred their diabetic patients according to the guidelines of the American Academy of Ophthalmology. Additionally, only 52 (36.9%) physicians educated their patients regarding the early detection of diabetic complications.

Conclusion

The present study concluded that there exist gaps in applying the correct guidelines. Physicians’ attitudes toward patient education were overall satisfactory. Further medical symposiums and workshops are warranted to teach physicians about diabetic complications and screening schedules, including DR.

Awareness and knowledge of diabetic retinopathy and associated factors in Goa: A hospital-based cross-sectional study

Purpose

To assess the awareness and knowledge about diabetic retinopathy (DR) and associated factors among patients visiting the tertiary health center in Goa.

Methods

A cross-sectional descriptive study was conducted using a standard predesigned and pretested closed-ended structured questionnaire to assess the awareness, knowledge, attitude and practice about DR among patients visiting a tertiary health center.

Results

Three hundred and fifty-eight subjects participated in the study. Only 125 (34.9% [95% CI: 30.0-40.1]) subjects were aware of DR and 122 (34.1% [95% CI: 29.2-39.2]) had adequate knowledge about DR. Awareness and knowledge of DR were significantly high among the subjects who completed college level of education (66.7%, OR = 2.78; 95% CI: 1.73-4.48, P < 0.001 and 55.9%, OR = 3.92; 95% CI: 2.41-6.38, P < 0.001) and who spoke English (52.5%, OR = 3.37; 95% CI: 2.14-5.30, P < 0.001 and 50.4%, OR = 3.26; 95% CI: 2.07-5.14, P < 0.001). Christians reported better knowledge about DR compared to other religions (48.8%, OR = 2.27; 95% CI: 1.38-3.75, P = 0.005). Negative association was noted between the knowledge of DR and presence of diabetes (29.4%, OR = 0.64; 95% CI: 0.41-0.99, P = 0.048). The practice pattern was strongly associated (OR = 7.47; 95% CI: 4.51-12.38, P < 0.001) with the knowledge of DR. Attitude was not influenced by any of the factors.

Conclusion

We found that awareness and knowledge about DR were unsatisfactory; literacy contributed significantly toward it. These findings also suggest that there is an immediate need to enhance the awareness and knowledge of diabetic eye diseases in order to reduce the burden of visual impairment.

Association of Demographic Variables with the Awareness of Type 2 Diabetes Mellitus Patients (T2DM) among the Northwest Population in Saudi Arabia

The chronic hyperglycemia in diabetes is associated with long-term damage, dysfunction, and failure of different organs. Lack of patient education and knowledge about these complications can worsen the quality of a patient's life. Hence, more efforts are needed to improve patient's education especially in rural areas. Aim. Our objective is to explore the association between demographic variables and the knowledge of self-care practices in type 2 diabetes mellitus. Methods. We used observational cross-sectional descriptive study using a validated self-administered questionnaire in both Arabic and English languages as well. A descriptive correlation design analyzed the questionnaire completed by a convenience sample meeting the inclusion criteria. Results. A total of 100 patients met the inclusion criteria for the analysis out of 3251 patients who completed the questionnaire. The study population has low moderate knowledge in diabetes, moderate knowledge in self-care practices, and good knowledge about complications of nephropathy and cardiovascular disease. No significant association between demographic variables. However, better knowledge observed in male (p = 0.028) and self-care practices with female (p = 0.020). Further, educational status is significantly influencing the knowledge of diabetic patients. Conclusion. The study emphasizing irrespective of demographic variable and the importance of patient education to achieve well glycemic control.

Barriers for Adherence to Diabetic Retinopathy Screening among Saudi Adults

Background

Diabetic retinopathy (DR) is one of the major complications of diabetes mellitus (DM) and the leading cause of blindness among adults. However, adherence to diabetic retinopathy screening (DRS) significantly reduces blindness. A substantial proportion of diabetics have suboptimal compliance to DRS, which inversely affects their outcomes. Therefore, the aim of this study is to determine the level of adherence to DRS and to explore the factors possibly associated with poor adherence to regular screening among diabetics in Riyadh, Saudi Arabia.

Method

A cross-sectional study was conducted that encompassed 404 adult diabetic patients attending outpatient clinics in four hospitals in Riyadh. A validated, self-administered questionnaire was used for data collection that included five main sections: sociodemographic data, diabetic profile, assessment of knowledge about DR, attitude toward DRS, and barriers to DRS. Data were analyzed by SPSS, version 23 (IBM Corp., Armonk, NY); qualitative variables were described as percentages, and quantitative variables were described as means ± standard deviation (SD). We used the chi-square test to measure the associations between qualitative variables and binary logistic regression analysis to predict the independent barriers to DRS.

Result

The average age of the participants was 54 years, and 69.1% were females. The average duration of diabetes was 12.3 years. Type 2 DM was the most prevalent form of DM (63.6%). DR was reported by 20% of participants. Poor knowledge about DRS was prevalent in 51%. More than one-fifth were never screened for DR. About one-third of participants agreed that cost was an important contributing barrier. Adequate knowledge, increased duration of diabetes, and presence of neurological complications increased independent adherence to screening.

Conclusion

One-fifth of participants reported having DR. Half the participants had poor knowledge about DR, which formed a major barrier against regular screening. However, most participants had positive attitudes about DR screening. Therefore, intervention strategies to increase patients’ awareness of DR might be the cornerstone of ensuring proper adherence to DRS.

Microvascular complications among patients with diabetes: An emerging health problem in Saudi Arabia

Diabetes mellitus, besides disrupting the carbohydrate metabolism process, also induces vascular disease and impacts nearly all the types and sizes of blood vessels. In fact, vascular complications cause majority of the morbidity, hospitalizations and mortality of patients with diabetes mellitus. Retinopathy, nephropathy and neuropathy (microvascular complications) impact hundreds of millions of diabetics and normally target those having long-term or uncontrolled forms of the disease; however, these disorders can also exist at the time of diagnosis or in those yet to be diagnosed. The Kingdom of Saudi Arabia is the biggest country in the Middle East that occupies around four-fifths of the Arabian Peninsula supporting a population of more than 33.3 million people. The prevalence of diabetes mellitus is increasing at an alarming rate in Saudi Arabia. Over 25% of the adult population is suffering and that figure is projected to more than double by 2030. In fact, diabetes mellitus has approximately registered a 10-fold upsurge in the past three decades in Saudi Arabia. However, the prevalence and risk factors of microvascular complications in diabetes mellitus patients have not yet been clearly documented in Saudi Arabia. Hence, in this review, we aim to provide an overview of the microvascular complications among patients with diabetes in Saudi Arabia, utilizing data from the currently available published literature. This is an attempt to facilitate the government and healthcare systems aware of the enormous worth of prevention, early detection and appropriate management of such microvascular complications.

Diabetic patients' awareness of diabetic retinopathy symptoms and complications

Background:

Diabetes is a very common chronic endocrinological disease. A total of 8.8% of the adult population worldwide was diabetics. Diabetic retinopathy is a silent disease, early detection and intervention is essential for its management and prognosis.

Aim:

To assess the diabetic patients’ awareness of diabetic retinopathy symptoms and complications.

Methods:

This is a cross-sectional community-based study which was conducted in Saudi Arabia using a survey from the period between June and September 2018 on all diabetic Saudi participants between 15 and 75 years of age.

Results:

This study involved 385 participants. The average age of the participants was 47.82 ± 14.49. The study only involved patients who were diagnosed with type 1 diabetes mellites (DM) or 2 DM. And 81% of the samples were diagnosed with type 2 DM. A total of 311 participants were aware of the DM effect on the eye. There was a significant difference between gender regarding the effect of DM on the retina in good control patients. On the subject of the source of participants’ knowledge of DM and its complication, there was a notable difference between groups.

Conclusion:

An acceptable level of knowledgewas noted among patients. However, some points of knowledge should be increased.

Comparative analysis of the main active components and hypoglycemic effects after the compatibility of Scutellariae Radix and Coptidis Rhizoma

In this study, a rapid and highly sensitive ultra high performance liquid chromatography with triple quadrupole mass spectrometry method with the mobile phase of acetonitrile and 0.1% aqueous formic acid was established and successfully applied to comparatively analyze main active components after their compatibility. Besides, the effects of Scutellariae Radix, Coptidis Rhizoma and combined extracts on type 2 diabetic rats induced by high-fat diet along with low dose of streptozocin were investigated. Under the optimized chromatographic conditions, good separation of seven target components was achieved within 12 min. All calibration curves exhibited good linearity (R²  ≥ 0.999). The relative standard deviation of precision, repeatability and stability varied from 0.69 to 2.23, 0.98 to 2.56, and 0.92 to 2.57%, respectively. The recovery ranged from 91.11 to 105.35%. The contents of seven active components were notably reduced after compatibility; however, the hypoglycemic effect of combined extracts was stronger than single drug by decreasing the activities of fructose-1,6-bisphosphatase, glucose 6-phosphatase, phosphoenolpyruvate carboxykinase and increasing the activities of glucokinase, phosphofructokinase, pyruvate kinase. Accordingly, the established analytical method was accurate and sensitive enough for quantitative evaluation of seven investigated compounds. Moreover, the combined extract had definite effects on type 2 diabetes through multiple components against multiple targets.

Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in primary health care in security forces hospital Riyadh, Saudi Arabia

Background

Diabetes mellitus (DM) is a metabolic disease that is characterized by distortion in the metabolism of carbohydrates, lipids, and proteins and involves hyperglycemia. DM has different types. Several complications are associated with diabetes including diabetic retinopathy (DR). DR can further results in bad outcomes that can be avoided by early diagnosis and management.

Aim

The aim of this paper is to assess the awareness and knowledge level about DR among type 2 DM patients in primary health care in security forces hospital.

Methods

This is a cross-sectional study that was conducted on Saudi patients with type 2 DM who visited primary health care in security forces hospital.

Results

This study included 174 participants, with equal male to female ratio was 1:1, there were 64.9% participants who reported controlled blood glucose level, and 47.1% reported that eye was affected by diabetes. There were 82.8% participants who had awareness about DR; the level of awareness differs significantly with sex (P value = 0.04) and the level of DM control (P value = 0.02).

Conclusion

There was high level of knowledge regarding DR; however, there were few percent of participants who had no awareness and still at risk.

Awareness, knowledge, and practices related to diabetic retinopathy among diabetic patients in primary healthcare centers at Riyadh, Saudi Arabia

Context

Diabetic retinopathy (DR) is a microvascular complication for diabetes mellitus (DM), with around 35% of diabetic patients developing some form of DR.

Aims

This study assessed the awareness toward DR, practice of regular eye examination, and DM control among diabetic patients.

Settings and Design

This was a cross-sectional study among diabetics at two primary healthcare centers in Riyadh, Saudi Arabia, who were selected by convenience sampling.

Methods and Materials

The questionnaire contained sections for demography, knowledge, attitude, and practice toward DR, and compliance to DM treatment. The association of awareness about retinopathy with demographics was compared.

Statistical Analysis Used

The association of awareness about retinopathy and education level with demographics and compliance with treatment were compared using Chi-square test.

Results

In total, 280 diabetic patients were included, 187 (67%) were males, mean age was 58.9 ± 10.1 years, and median duration of diabetes was 10 years. There was good awareness about DR, diabetes was well controlled in 170 (61%) patients, but less than half (45%) had their eyes checked within 1 year. Patients with education level of high school and above had higher awareness than those with no formal education (P < 0.001). Also, those with income level >10,000 SR had higher awareness than those with income ≤5,000 SR (P < 0.05).

Conclusion

There was high awareness among the diabetic patients regarding DR but annual check-up was done in less than half of the patients. Improvement is required for scheduling annual eye examinations for the early detection of DR.