Analysis of the status and influencing factors of diabetics’ awareness of diabetic retinopathy in Funing County, Jiangsu Province_Chinese Journal of Ocular Fundus Diseases

Authors：

Liu Biyu ¹ , Liu Jian ¹ , Hu Hongxia ¹ , Liu Qinghuai ² , Liu Bihong ¹ ,  Shen Han ²

1. Funing Shizhuang Eye Hospital, Yancheng 224431, China;
2. Department of Opthalmology, Affiliated Hospotal of Nanjing Medical University, Nanjing 210029, China;

Corresponding author：

Shen Han, Email: shenhan1991@163.com

Keywords：

Diabetic retinopathy; Root cause analysis; Prevention and control knowledge rate

DOI：

10.3760/cma.j.cn511434-20220418-00223

Video：

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Objective To analyze the status and influencing factors of awareness of diabetic retinopathy (DR) knowledge in diabetics in Funing County, Jiangsu Province. Methods This is a cross-sectional study. In 2021, a total of 2 125 residents with diabetes in Funing County, Jiangsu Province were recruited using cluster random sampling methods. General examinations were performed and ophthalmological evaluation were conducted including visual acuity in daily life, slit lamp microscope with preset lens, digital non-mydriatic fundus photography. Clinical assessment and classification of DR were according to the international standard clinical classifications of diabetic retinopathy in 2019. DR was classified into no obvious DR, mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR). Field questionnaire surveys were conducted to show the awareness rate of DR knowledge. Then Chi-square test and Logistic regression analysis were used to investigate influencing factors. Results Among 2 125 subjects, 762 (35.86%, 762/2 125) residents were male and 1 363 (64.14%, 1 363/2 125) residents were female. A total of 444 (20.89%, 444/2 125) subjects were diagnosed as DR. Among which, 438 (20.61%, 438/2 125) subjects were NPDR, 6 (0.28%, 6/2 125) subjects were PDR. A total of 419 (19.72%, 419/2 125) subjects were diagnosed as cataract. The topic awareness rates were all below 45.00%. The overall population awareness rate was 19.45% (4 959/25 500). Awareness rate was correlated with age, visual acuity in daily life, education level, family history of diabetes, diabetic retinopathy grades and the type of treatment for diabetes (P＜0.001). Logistic regression analysis showed that the knowledge rate of prevention and treatment of DR Decreased significantly in patients aged 60-79 compared with those aged under 50 (P＜0.05). Compared with those with visual acuity＜0.1 in daily life, the knowledge rate of DR prevention and treatment in those with visual acuity≥0.1 was significantly decreased (P＜0.05). While primary school to college education, with family history of diabetes, with DR, oral hypoglycemic agents and/or insulin treatment were associated with higher awareness rate (P＜0.05). Conclusions The DR knowledge level is low among diabetics in Funing County, Jiangsu Province in 2021. Age, visual acuity in daily life, education level, family history of diabetes, with DR and receiving drug treatments are main influencing factors for diabetic’s awareness.

Citation： Liu Biyu, Liu Jian, Hu Hongxia, Liu Qinghuai, Liu Bihong, Shen Han. Analysis of the status and influencing factors of diabetics’ awareness of diabetic retinopathy in Funing County, Jiangsu Province. Chinese Journal of Ocular Fundus Diseases, 2022, 38(12): 1006-1012. doi: 10.3760/cma.j.cn511434-20220418-00223 Copy

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16.	Kawasaki R, Konta T, Nishida K. Lipid-lowering medication is associated with decreased risk of diabetic retinopathy and the need for treatment in patients with type 2 diabetes: a real-world observational analysis of a health claims database[J]. Diabetes Obes Metab, 2018, 20(10): 2351-2360. DOI: 10.1111/dom.13372.
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1. Cheung N, Mitchell P, Wong T. Diabetic retinopathy[J]. Lancet, 2010, 376(9735): 124-136. DOI: 10.1016/s0140-6736(09)62124-3.
2. 彭云, 郭千千, 刘军安, 等. 深圳市社区糖尿病患者视网膜病变防治知识知晓度及影响因素分析[J]. 中华眼底病杂志, 2021, 37(1): 21-26. DOI: 10.3760/cma.j.cn511434-20201119-00570.Peng Y, Guo QQ, Liu JA, et al. A survey of awareness of retinopathy among diabetic patients in communities of Shenzhen[J]. Chin J Ocul Fundus Dis, 2021, 37(1): 21-26. DOI: 10.3760/cma.j.cn511434-20201119-00570.
3. 苏加丽, 张怡, 许英. 上海市花木社区居民糖尿病视网膜病变防治知识及行为现况调查研究[J]. 中国全科医学, 2018, 21(20): 2493-2498. DOI: 10.3969/j.issn.1007-9572.2018.00.136.Su JL, Zhang Y, Xu Y. Survey on the awareness and prevention of diabetic retinopathy among patients with diabetes mellitus and impaired glucose tolerance in the huamu community of Shanghai city[J]. Chinese General Practice, 2018, 21(20): 2493-2498. DOI: 10.3969/j.issn.1007-9572.2018.00.136.
4. 胡娣, 徐宏辉. 上海某镇糖尿病患者的糖尿病视网膜病变防治知识知晓情况调查[J]. 上海医药, 2019, 40(6): 44-45, 62. DOI: 10.3969/j.issn.1006-1533.2019.06.015.Hu D, Xu HH. Investigation of the knowledge of prevention and treatment of diabetic retinopathy in diabetic patients in a community of Shanghai[J]. Shanghai Medical & Pharmaceutical Journal, 2019, 40(6): 44-45, 62. DOI: 10.3969/j.issn.1006-1533.2019.06.015.
5. 邵洁, 徐飞燕, 胡燕华. 社区糖尿病患者视网膜病变认知度调查及影响因素分析[J]. 中国社区医师, 2019, 35(32): 49, 51. DOI: 10.3969/j.issn.1007-614x.2019.32.032.Shao J, Xu FY, Hu YH. Investigation of awareness of retinopathy in community diabetic patients and analysis of its influencing factors[J]. Chinese Community Doctors, 2019, 35(32): 49, 51. DOI: 10.3969/j.issn.1007-614x.2019.32.032.
6. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J]. Diabet Med, 1998, 15(7): 539-553. DOI: 10.1002/(sici)1096-9136(199807)15:7<539::Aid-dia668>3.0.Co;2-s.
7. 熊毅, 刘丽萍, 陈雁, 等. 上海淞南社区糖尿病患者对糖尿病视网膜病变的认知度调查[J]. 国际眼科杂志, 2015, 15(7): 1117-1122. DOI: 10.3980/j.issn.1672-5123.2015.7.01.Xiong Y, Liu LP, Chen Y, et al. Survey on the awareness of diabetic retinopathy among people with diabetes in the Songnan community of Shanghai[J]. Int Eye Sci, 2015, 15(7): 1117-1122. DOI: 10.3980/j.issn.1672-5123.2015.7.01.
8. 中华医学会糖尿病学分会视网膜病变学组. 糖尿病相关眼病防治多学科中国专家共识(2021年版)[J]. 中华糖尿病杂志, 2021, 13(11): 1026-1042. DOI: 10.3760/cma.j.cn115791-20211006-00534.Diabetic Retinopathy Group of Chinese Diabetes Society. Chinese multidisciplinary expert consensus on the prevention and treatment of diabetic eye disease (2021 edition)[J]. Chin J Diabetes Mellitus, 2021, 13(11): 1026-1042. DOI: 10.3760/cma.j.cn115791-20211006-00534.
9. 中华医学会糖尿病学分会视网膜病变学组. 糖尿病视网膜病变防治专家共识[J]. 中华糖尿病杂志, 2018, 10(4): 241-247. DOI: 10.3760/cma.j.issn.1674-5809.2018.04.001.Diabetic Retinopathy Group of Chinese Diabetes Society. Expert consensus on prevention and treatment of diabetic retinopathy[J]. Chin J Diabetes Mellitus, 2018, 10(4): 241-247. DOI: 10.3760/cma.j.issn.1674-5809.2018.04.001.
10. 李建军, 徐亮. 白内障影像评估的新方式[J]. 眼科, 2010, 19(2): 76-78.Li JJ, Xu L. A new method of cataract imaging evaluation[J]. Ophthalmol CHN, 2010, 19(2): 76-78.
11. Zhou Y, Li G, Li H. Automatic cataract classification using deep neural network with discrete state transition[J]. IEEE Trans Med Imaging, 2020, 39(2): 436-446. DOI: 10.1109/tmi.2019.2928229.
12. 陈淑莹, 王开杰, 万修华. 人工智能在白内障诊断和分级中的应用[J]. 国际眼科纵览, 2021, 45(3): 231-236. DOI: 10.3760/cma.j.issn.1673-5803.2021.03.011.Chen SY, Wang KJ, Wan XH. Artificial intelligence in diagnosis and classification of cataract[J]. Int Rev Ophthalmol, 2021, 45(3): 231-236. DOI: 10.3760/cma.j.issn.1673-5803.2021.03.011.
13. Hua R, Qu L, Ma B, et al. Diabetic optic neuropathy and its risk factors in Chinese patients with diabetic retinopathy[J]. Invest Ophthalmol Vis Sci, 2019, 60(10): 3514-3519. DOI: 10.1167/iovs.19-26825.
14. 潘新锋, 丁园, 陈润洁, 等. 2018年上海市居民健康素养水平及其影响因素分析[J]. 中国健康教育, 2020, 36(2): 99-102. DOI: 10.16168/j.cnki.issn.1002-9982.2020.02.001.Pan XF, Ding Y, Chen RJ, et al. Analysis on health literacy level and its influencing factors among residents in Shanghai, 2018[J]. Chinese Journal of Health Education, 2020, 36(2): 99-102. DOI: 10.16168/j.cnki.issn.1002-9982.2020.02.001.
15. 李世聪, 卢玲玲, 严维娜, 等. 2021年广东省成年居民营养健康素养现况特征分析[J]. 中国健康教育, 2022, 38(1): 23-27, 43. DOI: 10.16168/j.cnki.issn.1002-9982.2022.01.005.Li SC, Hu LL, Yan WN, et al. Analysis on the characteristics of nutritional health literacy among adult residents in Guangdong Province, 2021[J]. Chinese Journal of Health Education, 2022, 38(1): 23-27, 43. DOI: 10.16168/j.cnki.issn.1002-9982.2022.01.005.
16. Kawasaki R, Konta T, Nishida K. Lipid-lowering medication is associated with decreased risk of diabetic retinopathy and the need for treatment in patients with type 2 diabetes: a real-world observational analysis of a health claims database[J]. Diabetes Obes Metab, 2018, 20(10): 2351-2360. DOI: 10.1111/dom.13372.
17. Gange W, Lopez J, Xu B, et al. Incidence of proliferative diabetic retinopathy and other neovascular sequelae at 5 years following diagnosis of type 2 diabetes[J]. Diabetes care, 2021, 44(11): 2518-2526. DOI: 10.2337/dc21-0228.
18. Lopez J, Gange WS, Lung K, et al. Response to Comment on Gange et al. Incidence of proliferative diabetic retinopathy and other neovascular sequelae at 5 Years following diagnosis of type 2 diabetes. Diabetes Care 2021; 44: 2518-2526[J]. Diabetes Care, 2022, 45(3): 61-62. DOI: 10.2337/dci21-0057.
19. Hong T, Mitchell P, de Loryn T, et al. Development and progression of diabetic retinopathy 12 months after phacoemulsification cataract surgery[J]. Ophthalmology, 2009, 116(8): 1510-1514. DOI: 10.1016/j.ophtha.2009.03.003.

Chinese Journal of Ocular Fundus Diseases

Analysis of the status and influencing factors of diabetics’ awareness of diabetic retinopathy in Funing County, Jiangsu Province

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