Main Article Content
The Objectives this research were 1) to explore incidence and prevalence of diabetic retinopathy (DR) among Type 2 Diabetes Mellitus (T2DM) patients, and 2) to study the predictive power of Hemoglobin A1c, fasting blood sugar, duration of having T2DM, health behaviour, health literacy, genetics, and income to the occurrence of DR among T2DM patients receiving care from public health centers. A retrospective study design was conducted from 1,084 chart records to explore the incidence and prevalence of DR. Then 153 participants were recruited to study predicting factors for the occurrence of DR. Data were collected from chart reviews and self-reported questionnaires; then analyzed using descriptive and logistic statistics analysis. The findings showed that the incidence rate of DR was 3 per 1,000 population, and the prevalence rate of DR was 134 per 1,000 population. Hemoglobin A1c, fasting blood sugar, duration of having T2DM, health behaviour, health literacy, genetics, and income altogether could predict the occurrence of DR by 47% (R2 = 0.47, p < .05). Hemoglobin A1c, fasting blood sugar, duration of having T2DM, and health literacy could reduce the risk of DR significantly (OR = 1.51, 95%CI = 1.04, 2.21, p < .05;OR = 1.01, 95%CI = 1.00, 1.02, p < .05; OR = 1.30, 95%CI = 1.16, 1.47, p < .05; and OR = 0.95, 95%CI = 0.92, 0.98, p < .05). The incidence and prevalence of DR were the important health index reflecting a serious complication among uncontrolled T2DM patients. Success in controlling blood sugar level and gaining health literacy helped patients reduce the risk for DR. Nurse practitioners could take the messages from this study to create proactive interventions/services for promoting healthy behaviour and health literacy to prevent or delay the occurrence of DR among T2DM patients.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
2. Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye and vision (London, England). 2015; 2:17.
3. Centers for Disease Control and Prevention. Diabetic retinopathy [Internet]. USA: CDC; 2017 [cited 2018 October 17]. Available from: https://www.cdc.gov/features/diabetic-retinopathy/index.html
4. American Academy of Ophthalmology. Diabetic Retinopathy – Asia [Internet]. USA: AAO; 2016 [cited 2018 June 20]. Available from: https://www.aao.org/topic-detail/diabetic-retinopathy-asia
5. Ting DS, Cheung GC, Wong TY. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clin Exp Ophthalmol. 2016;44(4):260-77.
6. Chanlalit W. Ocular complications from diabetes mellitus. Journal of Medicine and Health Sciences. 2016;23(2):36-45. (in Thai).
7. Health Department, Bangkok Metropolitan Administration. Annual report 2016. Bangkok: The Agricultural Co-operative Federation of Thailand Publishers; 2017. (in Thai).
8. Health Department, Bangkok Metropolitan Administration. Percentage of DM patients registered in in Public Health Centers, Bangkok report 2016 [Internet]. Bangkok: Health Department; 2016 [cited 2019 August 10]. Available from: https://apps.boe.moph.go.th/boeeng/annual/AESR2016/static/documents/sum-aesr/9/โรคเบาหวาน.pdf?fbclid=IwAR3KZQSNEKMwNNClkrsQAPMsNvXgDAdXOgTYAWhQsiR-DaZS6EH9YaPrYkY
9. Ungchusak K, Sawanpanyalert P, Swaddiwudhipong W, and Jiraphongsa C. Basics of Epidemiology. Nontha-buri: Field Epidemiologist Association of Thailand Publishers; 2016. (in Thai).
10. Cardoso CRL, Leite NC, Dib E, Salles GF. Predictors of Development and Progression of Retinopathy in Patients with Type 2 Diabetes: Importance of Blood Pressure Parameters. Sci Rep. 2017;7(1):4867.
11. Chaisongkram W. Prevalence and Risk Factors of Diabetic Retinopathy in Patients with type 2 Diabetes. Journal of Health Science. 2017;26(1):37-44. (in Thai).
12. Sangrudsamee J, Permsuwan U, Chinwong S. Factors predicting diabetic retinopathy in Uttaradit province. Bangkok: Faculty of Pharmacy Chiang Mai University Publishers; 2011. (in Thai).
13. Song P, Yu J, Chan KY, Theodoratou E, Rudan I. Prevalence, risk factors and burden of diabetic retinopathy in China: a systematic review and meta-analysis. J Glob Health. 2018;8(1):010803.
14. Rungsirisangratana C. Prevalence and Risk Factors of Diabetic Retinopathy Among Type 2 Diabetic Patients in Phra Samut Chedi Sawatyanon Hospital. JPMAT. 2017;7(2):179 –188. (in Thai).
15. Sirikaensine S, editors. Factors Related to Blood Glucose Level among Patients with Diabetes Mellitus Type II in Responsible Area of Tombon Health Promoting Hospital Ban Yang Luang Nuea, Kut Chik subdistrict, Mueang District, Nongbua Lamphu Province. Ubonratchathani university The 1st National Conference; 2016 July 29; Ubonratchathani, Thailand. (in Thai).
16. Buraphunt R, Muangsom N. Factors Affecting Uncontrolled T2DMMellitus of Patients in Sangkhom Hospital, Udonthani Province. Khonkaen University jphr. 2013;6(3):102-109. (in Thai).
17. Health Education Division. Health Literacy Survey for Diabetes and Hypertension patients [Internet]. Bangkok: Minitry of Public health; 2017 [cited 2018 August 3]. Available from: http://www.hed.go.th/news/5523. (in Thai).
18. Nimit-Arnun N. Apply Health literacy concept for the New Case Diabetes Mellitus Type II Patients. [Internet]. Bangkok: College of Nursing Sciences Christian University; 2018 [cited 2018 November 25]. Available from: http://nurse.dusit.ac.th/news/download-file?path=1/JaySLFTHTljpKyaO0FUnqXxKTcZgif77.pptx. (in Thai).
19. Chen GD, Huang CN, Yang YS, Lew-Ting CY. Patient perception of understanding health education and instructions has moderating effect on glycemic control. BioMed Central. 2014; 14:683.
20. Zhang X, Gao Y, Zhou Z, Wang J, Zhou Q, Li Q. Familial clustering of diabetic retinopathy in Chongqing, China, type 2 diabetic patients. Eur J Ophthalmol. 2010;20(5):911-8.
21. Hietala K, Forsblom C, Summanen P, Groop PH. Heritability of proliferative diabetic retinopathy. Diabetes. 2008;57(8):2176-80.
22. Grintsova O, Maier W, Mielck A. Inequalities in health care among patients with T2DMby individual socio-economic status (SES) and regional deprivation: a systematic literature review. Int J Equity Health. 2014; 13:43.
23. Lee YH. Socioeconomic differences among community-dwelling diabetic adults screened for diabetic retinopathy and nephropathy: The 2015 Korean Community Health Survey. PloS one. 2018;13(1):e0191496.
24. Prasat Neurological Institute. Clinical Practice Guidelines: Dementia 2012. Bangkok: Tana Press Co.,Ltd Publisher; 2013. (in Thai).
25. Wiersma W, Jurs SG. Research Methods in Education: An Introduction: Pearson/Allyn and Bacon; 2009.
26. Virutsettazin K, Reseach for health. Bangkok: Thammasapa Publisher; 2017. (in Thai).
27. Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373-9.
28. Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, et al. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25(6):391-5.
29. Kaeodumkoeng K. Health literacy: Access, understand and application 2nd ed. Nonthaburi: Amarin Printing and Publishing Public Company Limited; 2018. (in Thai).
30. Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 10th ed. Philadelphia: Wolters Kluwer Health; 2017.
31. Bialocerkowski A, Klupp N, Bragge P. Research methodology series: How to
read and critically appraise a reliability article. IJTR. 2010;17(3):114–120.
32. Bourne RR, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, et al. Causes of vision loss worldwide, 1990-2010: a systematic analysis. Lancet Glob Health. 2013;1(6):e339-49.
33. Rangsin R, Tassanawiwut P, Medical Research Network. An assessment on quality of care among patients diagnosed with T2DM and hypertension visiting hospitals in care of Ministry of Public Health and hospital in Bangkok in Thailand. Bangkok: Thailand government Publisher;2015. (in Thai).
34. Hu Y, Teng W, Liu L, Chen K, Liu L, Hua R, et al. Prevalence and risk factors of diabetes and diabetic retinopathy in Liaoning province, China: a population-based cross-sectional study. PloS one. 2015;10(3): e0121477.
35. Kulkarni S, Kondalkar S, Mactaggart I, Shamanna BR, Lodhi A, Mendke R, et al. Estimating the magnitude of diabetes mellitus and diabetic retinopathy in an older age urban population in Pune, western India. 2019;4(1): e000201.
36. Piyamat S, Muktabhant B, Singyabuth S. Prevalence and Associated Factors of Diabetic Retinopathy among Type 2 Diabetic Patients at Phochai Hospital, Roi-et Province. Khon kaen Graduate Research Conference; 2014 March 28; Khonkaen, Thailand. (in Thai).
37. Sompopsakun A, Uaarayaporn Y, Sukchan P, Hayeeaema P, Cheseni F, Tangnaphadol K, et al. Prevalence and risk factors of diabetic retinopathy among registered diabetic patient in Songkhla general Hospital. pnujr. 2012;4(3):29- 43. (in Thai).
38. Marin-Penalver JJ, Martin-Timon I, Sevillano-Collantes C, Del Canizo-Gomez FJ. Update on the treatment of type 2 diabetes mellitus. WJD. 2016;7(17):354-395.
39. Yun JS, Lim TS, Cha SA, Ahn YB, Song KH, Choi JA, et al. Clinical Course and Risk Factors of Diabetic Retinopathy in Patients with T2DMMellitus in Korea. Diabetes & metabolism journal. 2016;40(6):482-93.
40. Istek N, Karakurt P. Effect of Activities of Daily Living on Self-Care Agency in Individuals with Type 2 Diabetes. J Diabetes Mellitus. 2016; 06: 247-62.
41. Thongkool S. The Factors Affecting to Self-care Behaviors of Diabetes Patients at Tambon Health Promoting Hospital in UbonRatchathani Province. Journal for Public Health Research, Ubon Ratchathani Rajabhat University. 2014;3(2):70-87. (in Thai).