Prevalence and risk factors for diabetic retinopathy in north-central Nigeria

Background: To determine the prevalence, pattern and risk factors of Diabetic Retinopathy (DR) among patients with Diabetes Mellitus (DM) in a tertiary hospital in north-central Nigeria.Settings and Design: This was a hospital-based cross-sectional study conducted in Jos, north-central Nigeria. Materials and Methods: Consecutive adult patients with DM attending the endocrinology clinic who consented to the study were examined over a six-month period. Demographic data, duration of diabetes and history of any systemic disorder were obtained for each patient. A detailed ocular examination and fundus photography were performed and results of blood investigations such as Fasting Blood Glucose (FBG), Glycosylated Haemoglobin (HbA1c) and serum lipid profile were analysed. Data analysis was done with Statistical Package for Social Sciences (SPSS) version 16.0 software.Results: Three hundred and fifty-six patients were examined comprising of 120 (33.7%) males and 236 (66.3%) females giving a male to female ratio of 1:2. The mean age of the study population was 56.6 ± 12.3 years. Diabetic retinopathy and macular oedema were present in 66 (18.5%) and 51 (14.3%) patients respectively. Diabetes diagnosis of 10 years and above, FBG and HbA1c all had a statistically significant association with DR with p values <0.001.Conclusion: The prevalence of DR was 18.5% in a hospital cohort of diabetic patients in north-central Nigeria with long duration of diabetes and poor glycaemic control being the major risk factors for retinopathy. These findings highlight the need for regular eye screening and good glycaemic control in individuals with diabetes in our environment.  Funding: None declared Keywords: Diabetic retinopathy, diabetes mellitus, macular oedema, prevalence, blindnes

Perception of insulin therapy among patients with type 2 diabetes mellitus in Jos, North Central Nigeria

Background -The implementation of insulin in the management of type 2  diabetes mellitus is often necessary for better glycaemic control. However,  many still consider insulin therapy as the last resort. Several factors come  to play in the acceptance of insulin as a form of therapy by patients. This study evaluated the perception of insulin therapy among patients with type 2 diabetes mellitus.Methods- This was a descriptive cross-sectional study carried out at the Jos University Teaching Hospital (JUTH) Jos, North Central Nigeria. One hundred and eighty five persons (100 insulin naïve persons and 85 persons on  insulin) were recruited consecutively. The insulin treatment appraisal scale (ITAS) was used to evaluate the perception of insulin therapy among these patientsResults- fifty five (64.7%) females were on insulin while 64 (64%) were insulin naïve. The mean age was 52 ± 11 years and 59 ± 10 years in those on insulin and insulin naïve persons respectively. Twenty one (24.7%) persons on insulin and 33 (33%) insulin naïve persons had tertiary level of education. Insulin naïve persons had higher mean total score of the 20 items, total score of the 16 negative items and total score of the 4 positive items compared with persons on insulin. Among persons on insulin, those with less than one year of education had a better perception of insulin therapy compared with persons who had six years or more of education; Duration of insulin use, gender and age had no impact on perception of insulin therapy.Conclusion- The perception of insulin therapy among persons with type 2 diabetes mellitus is poor.Key words-Insulin, insulin treatment appraisal scale, type 2 diabetes mellitus, perception of insulin therap