National trends in the prevalence of diabetic retinopathy among Thai patients with type 2 diabetes and its associated factors from 2014 to 2018

Abstract

Introduction Diabetic retinopathy (DR) is one of the most common and serious ocular complications in both developed and developing countries. To date, epidemiological data of DR and their associated factors in Southeast Asian countries especially in Thailand are scarce. We aimed to use the information from the Thailand Diabetes Mellitus/Hypertension (DM/HT) study to determine trends in DR prevalence and also risk factors among Thai patients with type 2 diabetes (T2D). Methods A series of cross-sectional surveys of clinical outcomes was conducted annually in 2014, 2015 and 2018 among patients with T2D aged >18 years receiving medical care for at least 12 months. A stratified single stage cluster sampling method that was proportional to the size sampling technique was used to select a nationally and provincially representative sample of patients with T2D in Thailand. A standardized case report form was used to obtain the required information from medical records. Results A total of 104,472 Thai patients with T2D were included in the study from 2014 to 2018. The dominant proportion of participants, 70,756 (67.7%), were females. The overall prevalence of DR declined from 6.9% in 2014 to 6.3% in 2015 and 5.0% in 2018 (p for trend <0.001). The independent associated factors with DR included survey year, greater duration of DM, geographic region, hospital level, social security scheme, dyslipidemia, insulin therapy, high HbA1c level and elevated pulse pressure. Conclusion We reported a decreasing in trend in the prevalence of DR among Thai patients with T2D over one half decade. Patients with T2D should be encouraged to control their underlying diseases and engage in other effective interventions. When these modifiable risk factors can be inhibited, DR and other cardiovascular complications will be alleviated.

Incidence and Risk Factors of Diabetic Retinopathy Among Patients With Type 2 Diabetes in a Community Hospital, Central Thailand

“…The present study illustrated that the cumulative incidence of DR among patients with T2D was 5.33% which was comparable with one related report in Thailand. (10) However, compared with the incidences of DR in T2D in other countries, the incidence of those in this study were relatively low. (5)(6)(7)(8) Notably, the cumulative incidences of DR stratified by HbA1c level significantly differed.…”

“…(1)(2)(3)(4) Furthermore, the annual incidence of DR among patients with T2D were 4.0%, 5.0%, 10.4% and 12.7% in Europe, Sweden, the US, and China, respectively. (5)(6)(7)(8) Related studies have reported that essential risk factors for DR included duration of T2D diagnosis, history of insulin used (1 ,2, 4) , hemoglobin A1C level (1,4,9) , high blood pressure (4,9) , pulse pressure (10,11) and lengthy distance from home to obtain care. (12) In many countries such as Germany, the cost of DR increased with the severity of DR accounting for 1.5% of the cost to the public health system in 2002.…”

Prevalence of and Factors Associated with Diabetic Retinopathy in Patients with Diabetes Mellitus at Siriraj Hospital – Thailand’s Largest National Tertiary Referral Center

“… 3 Among Thai patients with type 2 DM, the previously reported decrease in the overall prevalence of DR over a 5-year period may be explained by improved diabetic care due to Thai national health policy. 25 …”

Prevalence and Associated Factors in the Decline of Renal Function Among Outpatients Attending a Community Hospital, Central Thailand

“…The relationship between elevated PP and decline of renal function may be explained by the process of cardiovascular aging as in arterial stiffness at both macrovascular and microvascular. (24)(25)(26) Therefore, PP might constitute a noninvasive proxy indicator for the decline of renal function. (27) The study employed a cross-sectional survey, making it difficult to establish a cause-and-effect relationship between associated factors and decline of renal function.…”