Prevalence of diabetic retinopathy in India stratified by known and undiagnosed diabetes, urban–rural locations, and socioeconomic indices: results from the SMART India population-based cross-sectional screening study

Raman, Rajiv; Vasconcelos, Joana; Rajalakshmi, Ramachandran; Prevost, A Toby; Ramasamy, Kim; Mohan, Viswanathan; Deepa, Mohan; Rani, Padmaja Kumari; Conroy, Dolores M.; Das, Taraprasad; Sivaprasad, Sobha; Bhende, Pramod; Surya, Janani; Gopal, Lingam; Ramakrishnan, R.; Roy, Rupak; Das, Supita; Manayath, George J; Pooleeswaran, Vignesh T; Anantharaman, Giridhar; Gopalakrishnan, Mahesh; Natarajan, Sundaram; Krishnan, Radhika; Mani, Sheena Liz; Agarwal, Manisha; Behera, Umesh Chandra; Bhattacharjee, Harsha; Barman, Manabjyoti; Sen, Alok; Saxena, Moneesh; Sil, Asim Kumar; Chakrabarty, Subhratanu; Cherian, Thomas; Jitesh, Reesha; Naigaonkar, Rushikesh; Desai, Abishek; Kulkarni, Sucheta

doi:10.1016/s2214-109x(22)00411-9

Cited by 27 publications

(16 citation statements)

References 13 publications

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“…Notably, this study recruited people from age 40 years or above unlike other epidemiological studies on diabetes in India that have a lower age limit of 20 years. 4,5 This is because the primary objective of this study was to estimate the burden of complications of diabetes especially DR. 31 Our results confirm previous observations that the prevalence of known diabetes in urban residents is almost double that of the rural population. 4 The main concern regarding diabetes in LMICs is the earlier onset of complications of diabetes in their working life.…”

Section: Known Diabetessupporting

confidence: 91%

Burden of undiagnosed and suboptimally controlled diabetes in selected regions of India: Results from the SMART India population‐level diabetes screening study

Rajalakshmi,

Vasconcelos,

Prevost

et al. 2023

Diabet Med

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AimsTo estimate the prevalence of undiagnosed diabetes and suboptimally controlled diabetes and the associated risk factors by community screening in India.MethodsIn this multi‐centre, cross‐sectional study, house‐to‐house screening was conducted in people aged ≥40 years in urban and rural areas across 10 states and one union territory in India between November 2018 and March 2020. Participants underwent anthropometry, clinical and biochemical assessments. Capillary random blood glucose and point‐of‐care glycated haemoglobin (HbA1c) were used to diagnose diabetes. The prevalence of undiagnosed diabetes and suboptimal control (HbA1c ≥53 mmol/mol [≥7%]) among those with known diabetes was assessed.ResultsAmong the 42,146 participants screened (22,150 urban, 19,996 rural), 5689 had known diabetes. The age‐standardised prevalence of known diabetes was 13.1% (95% CI 12.8–13.4); 17.2% in urban areas and 9.4% in rural areas. The age‐standardised prevalence of undiagnosed diabetes was 6.0% (95% CI 5.7–6.2); similar in both urban and rural areas with the highest proportions seen in the East (8.0%) and South (7.8%) regions. When we consider all people with diabetes in the population, 22.8% of individuals in urban areas and 36.7% in rural areas had undiagnosed diabetes. Almost 75% of the individuals with known diabetes had suboptimal glycaemic control.ConclusionsHigh prevalence of undiagnosed diabetes and suboptimally controlled diabetes emphasises the urgent need to identify and optimally treat people with diabetes to reduce the burden of diabetes.

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Section: Known Diabetessupporting

confidence: 91%

Burden of undiagnosed and suboptimally controlled diabetes in selected regions of India: Results from the SMART India population‐level diabetes screening study

Rajalakshmi,

Vasconcelos,

Prevost

et al. 2023

Diabet Med

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“…The prevalence was found to be 12.5% in India. 9 This is probably due to insufficient public awareness of DR as well as inadequate screening.…”

Section: Discussionmentioning

confidence: 99%

A study on the prevalence of retinopathy in newly diagnosed Type 2 diabetes mellitus in a tertiary care center of Tamil Nadu

Prakash

M²,

Kalaisezhian³

et al. 2023

Asian J Med Sci

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Background: Type 2 diabetes mellitus (Type 2 DM) is one of the leading risk factors for cardiovascular diseases. Although the awareness of the need for screening and treatment for Type-2 DM is widely prevalent, the awareness of complications arising out of it is not widespread. This article highlights the occurrence of diabetic retinopathy (DR) among newly detected diabetic patients. Aims and Objectives: The aim of the study was to study the prevalence of DR in patients who are diagnosed as having Type 2 diabetes mellitus for the first time. Materials and Methods: The present study involved 501 newly diagnosed Type 2 DM patients. Their history was recorded and the investigations done included haemoglobin (Hb), glycated Hb percent (HbA1c), fasting blood sugar, and post-prandial blood sugar. These patients underwent fundus examination through direct ophthalmoscope and slitlamp examination. Results: Out of the 501 patients in the study, 59.5% (298) had good knowledge about diabetes, but only 3.8% knew about retinopathy. A total of 71.5% of patients did not have periodic eye examination; the most common barrier identified was lack of awareness about the necessity for this (58.5%), 5.6% among the total population had an eye disease. Mild non-proliferative DR (NPDR) was found among 10 females and it was observed in eight males. Moderate NPDR was identified in three males and two females and while no severe cases were reported among the men, two were noted among the women. Conclusion: The study highlights the prevalence of retinopathy in newly diagnosed Type 2 DM population in tertiary care center hospital in Salem district. The study also highlights the importance of detection of Type 2 DM before the occurrence of complications which arise due to diabetes and screening for microvascular complications is necessary at the time of diagnosis of DM and periodically.

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“…In India, the occurrence of DR disease was analyzed using a survey by including both subjects with known diabetes and persons unaware of diabetes as shown in Table 1. 11 Based on studies conducted to understand DR prevalence worldwide from sources like PubMed, Medline, Web of Science, and Scopus, it is found that the global prevalence of DR disease remains high. According to the survey conducted in 2020 global prevalence of DR is estimated as 22.27% and the number of adults affected with DR is 103.12 million.…”

Section: Diabetic Retinopathymentioning

confidence: 99%

Artificial intelligence and hemodynamic studies in optical coherence tomography angiography for diabetic retinopathy evaluation: A review

Pradeep,

Jeyakumar,

Bhende

et al. 2023

Proc Inst Mech Eng H

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Diabetic retinopathy (DR) is a rapidly emerging retinal abnormality worldwide, which can cause significant vision loss by disrupting the vascular structure in the retina. Recently, optical coherence tomography angiography (OCTA) has emerged as an effective imaging tool for diagnosing and monitoring DR. OCTA produces high-quality 3-dimensional images and provides deeper visualization of retinal vessel capillaries and plexuses. The clinical relevance of OCTA in detecting, classifying, and planning therapeutic procedures for DR patients has been highlighted in various studies. Quantitative indicators obtained from OCTA, such as blood vessel segmentation of the retina, foveal avascular zone (FAZ) extraction, retinal blood vessel density, blood velocity, flow rate, capillary vessel pressure, and retinal oxygen extraction, have been identified as crucial hemodynamic features for screening DR using computer-aided systems in artificial intelligence (AI). AI has the potential to assist physicians and ophthalmologists in developing new treatment options. In this review, we explore how OCTA has impacted the future of DR screening and early diagnosis. It also focuses on how analysis methods have evolved over time in clinical trials. The future of OCTA imaging and its continued use in AI-assisted analysis is promising and will undoubtedly enhance the clinical management of DR.

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Prevalence of diabetic retinopathy in India stratified by known and undiagnosed diabetes, urban–rural locations, and socioeconomic indices: results from the SMART India population-based cross-sectional screening study

Cited by 27 publications

References 13 publications

Burden of undiagnosed and suboptimally controlled diabetes in selected regions of India: Results from the SMART India population‐level diabetes screening study

Burden of undiagnosed and suboptimally controlled diabetes in selected regions of India: Results from the SMART India population‐level diabetes screening study

A study on the prevalence of retinopathy in newly diagnosed Type 2 diabetes mellitus in a tertiary care center of Tamil Nadu

Artificial intelligence and hemodynamic studies in optical coherence tomography angiography for diabetic retinopathy evaluation: A review

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