Title: Influence of Socioeconomic and Demographic Factors on Diabetic Retinopathy

Authors: Ranjini Kotancheri, Arun Kumar Ayoor, Karthika P Jayan, Swathi Karuppali, Anu Bhaskar

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i9.116

Abstract

Introduction: Diabetes mellitus is fast emerging as a pandemic with its impact on the health system of the nation and the economic status of the patient. The ways by which the socioeconomic and demographic factors influence the progression of the disease and its vision threatening complication like retinopathy is still unclear. As these factors play a pivotal role in the management, we have undertaken this study to analyse the effects of them on the disease.

Methods: This cross sectional study was conducted among 257 diabetic patients attending ophthalmology department and data about the socioeconomic status, occupation, body mass index , place of residence and severity of diabetic retinopathy  were collected  and analysed .

Results: Out of 257 patients, 50.2% were males and 49.8% females with 77.8% from rural areas,35.8% in the  age group of 51-60 years.146 belonged to unemployed group 32 employed in gulf,57 skilled and 22 unskilled. Majority belonged to middle class families 70.4% (p value 0.022).Association of body mass index with retinopathy and Clinically Significant Macular Edema (CSME) with socioeconomic status showed insignificant correlation (p value 0.136).

Conclusion: Socioeconomic and demographic factors influence the development and progression of diabetic retinopathy. Greater severity of retinopathy was observed in the deprived classes of society and also among the rural population. Hence measures to adopt health policies to overcome the barrier of socioeconomic disparity in the availability of treatment and follow up should be implemented at the earliest to reduce sight threatening complication like retinopathy in the lower strata of the society.

Keywords: socioeconomic status, diabetic retinopathy, occupation, body mass index,  rural, clinically, Significant macular edema.

 

References

  1. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: preval-ence, numerical estimates, and projections. Diabetes care. 1998 Sep 1;21(9):1414-31.
  2. World Health Organization. Global report on diabetes. World Health Organization; 2016
  3. Low L, Law JP, Hodson J, McAlpine R, O'Colmain U, MacEwen C. Impact of socioeconomic deprivation on the development of diabetic retinopathy: a population-based, cross-sectional and longitudinal study over 12 years. BMJ open. 2015 Apr 1;5(4):e007290.
  4. Larranaga I, Arteagoitia JM, Rodriguez JL, Gonzalez F, Esnaola S, Pinies JA. Socio‐economic inequalities in the prevalence of Type 2 diabetes, cardio-vascular risk factors and chronic diabetic complications in the Basque Country, Spain. Diabetic Medicine. 2005 Aug 1;22(8):1047-53.
  5. Litwin AS, Clover A, Hodgkins PR, Luff AJ. Affluence is not related to delay in diagnosis of Type 2 diabetes as judged by the development of diabetic retinopathy. Diabetic medicine. 2002 Oct 1;19(10): 843-6.
  6. Raman R, Rani PK, Rachepalle SR, Gnanamoorthy P, Uthra S, Kumar-amanickavel G, Sharma T. Prevalence of diabetic retinopathy in India: Sankara Nethralaya diabetic retinopathy epidemic-ology and molecular genetics study report 2. Ophthalmology. 2009 Feb 28;116(2): 311-8
  7. Chaturvedi N, Stephenson JM, Fuller JH. The relationship between socioeconomic status and diabetes control and complications in the EURODIAB IDDM Complications Study. Diabetes care. 1996 May 1;19(5):423-30.
  8. Yang SH, Chen SF, Nieh S, Liu CL, Lin YS, Lee CC, Lin FH. The Effect of Individual and Neighbourhood Socioe-conomic Status on Diabetes Mellitus Survival in Working Age Patients in Taiwan. PloS one. 2017 Jan 12;12(1):e 0169550
  9. Osborn CY, De Groot M, Wagner JA. Racial and ethnic disparities in diabetes complications in the northeastern United States: the role of socioeconomic status. Journal of the National Medical Association. 2013;105(1):51.
  10. Funakoshi M, Azami Y, Matsumoto H, Ikota A, Ito K, Okimoto H, Shimizu N, Tsujimura F, Fukuda H, Miyagi C, Osawa S. Socioeconomic status and type 2 diabetes complications among young adult patients in Japan. PloS one. 2017 Apr 24;12(4):e0176087.

Corresponding Author

Dr Arun Kumar Ayoor

Professor of Ophthalmology,

Govt Medical College, Kozhikode, Kerala India Pin 673008

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Tel no.  9447286310