Key result
Self-reported non-adherence to drug therapy was independently associated with an increased odds of diabetic retinopathy (OR 1.82) among patients with type 2 diabetes in Bangladesh.
Why the study?
In Bangladesh, fundoscopy and evaluation of drug non-adherence are not regularly performed due to limited resources, leaving the prevalence of diabetic retinopathy and its determinants unknown.
Cross-Sectional (n=489)
No
Odds Ratio: 1.82 (95% CI 1.07–3.1)
Absolute Event Rate: 24.47% vs 13.49%
p-value: p=0.027
Diabetic retinopathy is highly prevalent (18.8%) among asymptomatic type 2 diabetic patients in Bangladesh, highlighting the need for regular screening even in resource-limited settings.
May support targeted retinopathy screening in non-adherent diabetics; hypothesis-generating for Southeast Asia.
Background: Diabetes mellitus is a major health problem in Southeast Asia and diabetic retinopathy is one of its most debilitating complications. Nevertheless, fundoscopy and systematic evaluation of non-adherence to drug therapy are not regularly done in individuals with diabetes in Bangladesh due to limited resources. Therefore, the prevalence of diabetic retinopathy and its determinants with non-adherence to drug therapy are not known. We, therefore, screened for diabetic retinopathy, non-adherence to drug therapy and other associated factors at a tertiary care hospital in Bangladesh.Methods: Between May 2017 to September 2017, we conducted a cross-sectional study of 489 systematically recruited asymptomatic, at least one-year type-2 diabetic individuals on medication and attending the outpatient department of the BIHS tertiary care centre in Dhaka, Bangladesh. We obtained a medical history, physical examination, routine laboratory tests, questionnaires, and fundus photography.Results: The prevalence of diabetic retinopathy among T2DM patients was 18.8%. Clinical factors associated with the presence of diabetic retinopathy were uncontrolled fasting blood glucose, known duration of diabetes of ≥10 years and self-reported non-adherence to drug therapy. With a known duration of diabetes of 15 years or more, the prevalence of diabetic retinopathy rose to 40%.Conclusions: Undiagnosed diabetic retinopathy is still common among patients in Bangladesh, even at tertiary care centres. It is associated with longer disease duration, poor metabolic control and self-reported non-adherence to therapy. Regular screening for diabetic retinopathy should therefore be implemented also in resource-limited settings and further efforts should be made to improve the patients’ drug adherence and metabolic control.
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Wahiduzzaman et al. (2022) conducted a cross-sectional in Type 2 diabetes mellitus (n=489). Non-adherence to drug therapy vs. Adherence to drug therapy was evaluated on Presence of diabetic retinopathy (OR 1.82, 95% CI 1.07-3.10, p=0.027). Self-reported non-adherence to drug therapy was independently associated with an increased odds of diabetic retinopathy (OR 1.82) among patients with type 2 diabetes in Bangladesh.