Diabetes Metab J.  2018 Dec;42(6):538-543. 10.4093/dmj.2018.0047.

The Prevalence and Risk Factors for Diabetic Retinopathy in Shiraz, Southern Iran

• Ghaem H
• Daneshi N
• Riahi S
• Dianatinasab M

• KMID: 2449631
• DOI: http://doi.org/10.4093/dmj.2018.0047

Abstract

Globally, diabetic retinopathy (DR) is one of the leading causes of blindness, that diminishes quality of life. This study aimed to describe the prevalence of DR, and its associated risk factors. This cross-sectional study was carried out among 478 diabetic patients in a referral center in Fars province, Iran. The mean±standard deviation age of the participants was 56.64±12.45 years old and DR prevalence was 32.8%. In multivariable analysis, lower education levels (adjusted odds ratio [aOR], 0.43; 95% confidence interval [CI], 0.24 to 0.76), being overweight (aOR, 1.70; 95% CI, 1.02 to 2.83) or obese (aOR, 1.88; 95% CI, 1.09 to 3.26), diabetes duration of 10 to 20 years (aOR, 2.35; 95% CI, 1.48 to 3.73) and over 20 years (aOR, 5.63; 95% CI, 2.97 to 10.68), receiving insulin (aOR, 1.99; 95% CI, 1.27 to 3.10), and having chronic diseases (aOR, 1.71; 95% CI, 1.02 to 2.85) were significantly associated with DR. In conclusion, longer diabetes duration and obesity or having chronic diseases are strongly associated with DR suggesting that control of these risk factors may reduce both the prevalence and impact of retinopathy in Iran.

Keyword

Diabetes; Diabetes duration; Diabetic retinopathy; Insulin; Prevalence; Risk factors

MeSH Terms

Blindness
Chronic Disease
Cross-Sectional Studies
Diabetic Retinopathy*
Education
Humans
Insulin
Iran*
Obesity
Odds Ratio
Overweight
Prevalence*
Quality of Life
Referral and Consultation
Risk Factors*
Insulin

Reference

1. Manaviat MR, Rashidi M, Afkhami-Ardekani M, Shoja MR. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients. BMC Ophthalmol. 2008; 8:10. PMID: 18513455.

2. Fenwick EK, Xie J, Ratcliffe J, Pesudovs K, Finger RP, Wong TY, Lamoureux EL. The impact of diabetic retinopathy and diabetic macular edema on health-related quality of life in type 1 and type 2 diabetes. Invest Ophthalmol Vis Sci. 2012; 53:677–684. PMID: 22205611.

3. Babazadeh T, Dianatinasab M, Daemi A, Nikbakht HA, Moradi F, Ghaffari-Fam S. Association of self-care behaviors and quality of life among patients with type 2 diabetes mellitus: Chaldoran County, Iran. Diabetes Metab J. 2017; 41:449–456. PMID: 29272083.

4. Al-Maskari F, El-Sadig M. Prevalence of diabetic retinopathy in the United Arab Emirates: a cross-sectional survey. BMC Ophthalmol. 2007; 7:11. PMID: 17572909.

5. Javadi MA, Katibeh M, Rafati N, Dehghan MH, Zayeri F, Yaseri M, Sehat M, Ahmadieh H. Prevalence of diabetic retinopathy in Tehran province: a population-based study. BMC Ophthalmol. 2009; 9:12. PMID: 19835608.

6. Santos-Bueso E, Fernandez-Perez C, Macarro A, Fernandez-Vigo J. Prevalence of diabetic retinopathy in the city of Badajoz 2002 (Extremadura project to prevent blindness). Arch Soc Esp Oftalmol. 2007; 82:153–158. PMID: 17357892.

7. Hu Y, Teng W, Liu L, Chen K, Liu L, Hua R, Chen J, Zhou Y, Chen L. Prevalence and risk factors of diabetes and diabetic retinopathy in Liaoning province, China: a population-based cross-sectional study. PLoS One. 2015; 10:e0121477. PMID: 25785633.

8. Shrestha MK, Paudyal G, Wagle RR, Gurung R, Ruit S, Onta SR. Prevalence of and factors associated with diabetic retinopathy among diabetics in Nepal: a hospital based study. Nepal Med Coll J. 2007; 9:225–229. PMID: 18298009.

9. Dianatinasab M, Fararouei M, Mohammadianpanah M, Zare-Bandamiri M, Rezaianzadeh A. Hair coloring, stress, and smoking increase the risk of breast cancer: a case-control study. Clin Breast Cancer. 2017; 17:650–659. PMID: 28549689.

10. Watkins PJ. Chapter 11, Management of diabetes during surgery and other illnesses. Diabetes and its management. 6th ed. Oxford: Blackwell Publishing;2003. p. 95–103.

11. Khatib OMN. World Health Organization. Guidelines for the prevention, management and care of diabetes mellitus. Cairo: World Health Organization;2006.

12. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus. Geneva: World Health Organization;1999.

13. Giloyan A, Harutyunyan T, Petrosyan V. The prevalence of and major risk factors associated with diabetic retinopathy in Gegharkunik province of Armenia: cross-sectional study. BMC Ophthalmol. 2015; 15:46. PMID: 25925666.

14. Narendran V, John RK, Raghuram A, Ravindran RD, Nirmalan PK, Thulasiraj RD. Diabetic retinopathy among self reported diabetics in southern India: a population based assessment. Br J Ophthalmol. 2002; 86:1014–1018. PMID: 12185129.

15. Zhang X, Saaddine JB, Chou CF, Cotch MF, Cheng YJ, Geiss LS, Gregg EW, Albright AL, Klein BE, Klein R. Prevalence of diabetic retinopathy in the United States, 2005-2008. JAMA. 2010; 304:649–656. PMID: 20699456.

16. Wong TY, Cheung N, Tay WT, Wang JJ, Aung T, Saw SM, Lim SC, Tai ES, Mitchell P. Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study. Ophthalmology. 2008; 115:1869–1875. PMID: 18584872.

17. Thomas RL, Dunstan F, Luzio SD, Roy Chowdury S, Hale SL, North RV, Gibbins RL, Owens DR. Incidence of diabetic retinopathy in people with type 2 diabetes mellitus attending the Diabetic Retinopathy Screening Service for Wales: retrospective analysis. BMJ. 2012; 344:e874. PMID: 22362115.

18. Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, Palacios J, Sullivan GD, Bindman AB. Association of health literacy with diabetes outcomes. JAMA. 2002; 288:475–482. PMID: 12132978.

19. Dirani M, Xie J, Fenwick E, Benarous R, Rees G, Wong TY, Lamoureux EL. Are obesity and anthropometry risk factors for diabetic retinopathy? The diabetes management project. Invest Ophthalmol Vis Sci. 2011; 52:4416–4421. PMID: 21482643.

20. McKay R, McCarty CA, Taylor HR. Diabetic retinopathy in Victoria, Australia: the Visual Impairment Project. Br J Ophthalmol. 2000; 84:865–870. PMID: 10906093.