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The Thai DMS Diabetes Complications (DD.Comp.) Project: Prevalence and Risk Factors of Diabetic Retinopathy in Thai Patients with Type 2 Diabetes Mellitus

Amporn Jongsareejit MD*, Somkiat Potisat MD**, Udom Krairittichai MD***, Charnvate Sattaputh MD****, Woranut Arunratanachote MS**

Affiliation : * Prasat Neurological Institute, Department of Medical Services, MOPH, Bangkok, Thailand ** Institute of Medical Research and Technology Assessment, Department of Medical Services, MOPH, Bangkok, Thailand *** Rajavithi Hospital, Department of Medical Services, MOPH, College of Medicine, Rangsit University, Bangkok, Thailand **** Lerdsin Hospital, Department of Medical Services, MOPH, Bangkok, Thailand


Objective : To determine the prevalence of diabetic retinopathy (DR) among patients with type 2 diabetes mellitus (T2DM) in Thailand and their associated risk factors. Material and Method: A cross-sectional, multi-sites, hospital-based study was carried out between June and December 2006. Diabetic patients from the outpatient department of seven public hospitals (3 tertiary, 2 secondary and 2 community hospital) in Thailand were performed by retinal specialist.
Results : One thousand seven of 1,120 diabetic patients received retinal examination using indirect ophthalmoscope. Patients were divided into two groups (absent and present DR). Most patients in both groups were female (72.7 and 68.0%). The prevalence of DR was 24.0% (n = 242), mild NPDR 9.4% (n = 95), moderate NPDR 10.5% (n = 106), severe NPDR 1.3% (n = 13), and proliferative (PDR) 2.8% (n = 28). Age at onset, duration of DM, systolic blood pressure, body mass index (BMI), fasting plasma glucose (FPG), HbA1c, Triglyceride (TG), alcohol consumption, foot ulcer, and proteinuria were recorded. Metformin and insulin taking were statistically, significantly different among these groups. There is more prevalent NPDR and PDR in insulin-taking than non-insulin-taking groups. The grading of diabetic retinopathy is associated with the duration of diabetes. In multivariate regression analysis, associated risk factors of DR patients were the duration of DM, HbA1c levels, and proteinuria.
Conclusion : Diabetic retinopathy was present in about one fourth of type 2 diabetic patients in this study. Associated risk factors of DR were the duration of DM, HbA1c levels, and proteinuria. Regular screening for DR especially in T2DM with associated risk factor should be done for early treatment.

Keywords : Diabetic retinopathy, Type 2 diabetes mellitus, HbA1c, Diabetic nephropathy


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JMed Assoc Thai
MEDICAL ASSOCIATION OF THAILAND
ISSN: 0125-2208 (Print),
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