Severity of Diabetic Retinopathy and Diabetic Retinopathy Awareness Among Diabetic Foot Ulcer Patients

1. Aida Mohd Zahidin
2. Lovenia Luxuman
3. Wong Koh Ging
4. Auji Azhani Mohd Zahir
5. Shireen Lui Siow Leng
6. Nurul Ilani Abdul Latif

University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia

Purpose: To determine stages of diabetic retinopathy among diabetic foot ulcer patients attending UKMMC and identify their level of diabetic awareness.

Methods: A cross sectional study was performed. Fundus photographs were taken and graded by 2 Ophthalmologists. Glycaemic control (HbA1c) was investigated to determine association with severity of diabetic retinopathy. Questionnaires were used to determine diabetic retinopathy awareness among respondents.

Results: Seventy two patients consisting of 45 males and 27 females with mean age of 60 years old were recruited. Among respondents, 10 (13.9%) have no retinopathy, 28 (38.9%) have non-proliferative retinopathy (19 (26.4%) mild, 6 (8.3%) moderate, 3 (4.2%) severe) and 34 (47.2%) have proliferative retinopathy. There was significant association between glycaemic control (HbA1c) and duration of diabetes with presence of diabetic retinopathy using Student's t-test with p=0.033 and p=0.036 respectively. However, on further sub-classification, there was no statistically significant difference between the severity of diabetic retinopathy and duration of diabetes nor glycaemic control using One-way ANOVA (p=0.077, p=0.103). More than 95% of patients were aware that diabetes mellitus could damage eyes, impair eyesight and cause blindness. Majority (95.8%) agreed that diabetic patients should visit an ophthalmologist, but only 84.7% had ever visited an ophthalmologist. 77.8% were aware that those with poor glycaemic control are at high risk of diabetic retinopathy.

Conclusions: Some form of diabetic retinopathy is usually present with longer duration of diabetes and poorer glycaemic control amongst diabetic foot ulcer patients. However, the severity of diabetic retinopathy did not show significant association with duration of diabetes nor glycaemic control. Most respondents were aware of diabetic eye-related complications.