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Top 8 Foods To Stop Diabetic Retinopathy - Diabetes Preventing - DiabetesAZ Diabetic Immune-boosting prebiotics is an eye condition edication can cause vision loss and blindness retinopatuy people Immune-boosting prebiotics Mood enhancer natural remedies and techniques diabetes. It affects blood vessels heqlth the retina the Diabetiic layer Immune-boosting prebiotics ehalth in the back of your eye. Diabetic retinopathy may not have any symptoms at first — but finding it early can help you take steps to protect your vision. Managing your diabetes — by staying physically active, eating healthy, and taking your medicine — can also help you prevent or delay vision loss. Diabetic retinopathy is the most common cause of vision loss for people with diabetes.Diabetic retinopathy health education -
Double vision caused by nerve damage or difficulty focusing due to vision fluctuations caused by fluid imbalance in the lens. Vision Health Initiative VHI Prevent Diabetes Complications: Vision Loss Take Charge of Your Diabetes: Healthy Eyes Diabetic Eye Disease Resources external icon Diabetic Retinopathy external icon Diabetic Retinopathy: Causes, Symptoms, Treatments external icon Eye Care of the Patient with Diabetes Mellitus external icon Eye Complications external icon.
US Department of Health and Human Services. HealthyPeople Primary Eye Care in Systemic Disease. McGraw-Hill; Centers for Disease Control and Prevention. Diabetes and Vision Loss.
Updated May 7, Accessed December 29, html Wykoff CC, Khurana RN, Nguyen QD, et al. Risk of blindness among patients with diabetes and newly diagnosed diabetic retinopathy.
Diabetes Care. Projection of diabetic retinopathy and other major eye diseases among people with diabetes mellitus: United States, — Arch Ophthalmol. Keep an Eye on Your Vision Health. Updated October 1, Accessed September 21, Following your diabetes ABCDEs and getting your eyes checked regularly by an ophthalmologist or optometrist are crucial to prevent vision loss or keep it from getting worse.
If you have diabetic retinopathy, very effective treatments are available. Your eye-care specialist will explain these to you.
You should get an eye exam once a year, unless your ophthalmologist or optometrist has suggested something different. The risk of vision loss can be greatly reduced with regular checks. Remember, you may not be aware of changes to your vision and many problems can be treated when caught early.
Diabetic retinopathy can worsen in pregnancy, so if you have diabetes you should have a diabetic eye exam before getting pregnant and while pregnant. During the eye exam, your eye-care provider uses a special magnifying instrument to look for any blood vessel damage at the back of your eye. Eye exams are a safe and necessary part of your diabetes management.
Contact your eye-care professional directly for an appointment or have your health-care provider refer you for an eye exam. The total sample size was calculated to be for the study. This person generated the random allocation sequence and distributed these in serially numbered sealed opaque envelopes.
The sealed envelopes were directly couriered to the tertiary hospital and were maintained in a locked cabinet under the supervision of an ophthalmic personnel. Envelopes were opened in a sequential manner serial number in participant list and serial number mentioned on top of envelope was the same in all cases in front of study participant and a witness usually family member of the participant , and intervention allocation was implemented accordingly.
increase in referral completion. Increase in knowledge about DR was measured using pre and post intervention questionnaires S3 and S4 Files based on a previously published study [ 22 ].
A total of nine questions were investigated to assess participants' knowledge on DR. Study participants were asked the same questions during post-intervention survey. The duration of the total health education package was 5 months and included one face-to-face session and telephonic reminders.
The CHWs received orientation to deliver the intervention from the Principle Investigator first author who is also a doctoral candidate of health sciences major. Interventions were delivered under the supervision of Principle Investigator.
The health education contents are outlined in S5 File. The contents were examined and approved by Ophthalmologists prior to field study. Telephonic reminders were delivered by the CHW who delivered the face-to-face intervention, so that participants could recognize and trust the caller as a result of rapport built during past interaction.
The face-to-face health education session was delivered in local Bengali language in about 30—40 minutes following an in-depth interview. It consisted of key information about Diabetes, DR, DR management options, and information about available services at the government tertiary hospital.
Communication materials used were a pictorial colorful portable flipchart used for demonstration purpose, colorful pictorial leaflet in native language Bengali and a waterproof referral card with important information which would help to measure primary endpoint referral compliance rate accurately.
Telephone reminders followed this on Day 7, 30 and 90 where each reminder call lasted about 15 minutes. Multiple reminders have previously been reported to be more effective than single reminder in improving DFE [ 23 ]. A similar past study had delivered face-to-face health education session followed by monthly reminders [ 24 ].
Our study restricted telephonic reminders to three because evidence suggests that after a third patient reminder, there is no incremental improvement in screening rates [ 23 ]. Telephonic reminders were discontinued for participants who completed referral compliance prior to the next scheduled call.
The contents of the face-to-face education session and telephonic sessions have been outlined in detail S5 File. Participants from the control group also received information regarding DR and referral instruction from the eye health service providers at the diabetes hospital, as same as the intervention group.
Participants of control group were not provided with any form of personalized health education face-to-face home-based education session followed by telephonic reminders. Analysis was conducted by Intention-to-treat ITT method.
We considered dropout participants to be those who did not receive our phone call or respond during the follow-up calls. All participants including those who dropped-out were included in analysis. Pearsons chi-square test was used to compare the referral compliance and changes in knowledge measures of the two groups.
Univariate analysis was conducted to test association of different variables with referral compliance as the primary endpoint. Subsequently, multivariate analysis with backward Likelihood Ratio LR binary logistic regression modeling was performed to identify significant predictors of referral compliance after adjusting for potential confounders.
For the secondary outcome, we compared the proportion of participants who provided correct or positive responses during pre and post intervention surveys.
This comparison was done between the two study arms. In addition, chi-square test was performed for each knowledge related question. There were no participants who initially provided correct or positive response at baseline and later incorrect or negative response during the post intervention survey.
Therefore, we conducted chi-square test only on those participants who initially provided incorrect or negative responses. Statistical Software for Social Science SPSS Version Due to the nature of the study design open label , it was not possible to withhold knowledge about allocated intervention to participants.
Therefore, to reduce bias, a data manager stationed at the tertiary hospital assessed outcome compliance in both intervention and control groups. In addition, the accuracy of the outcome assessment was checked every 2 weeks by data manager and then by ophthalmic personnel at the tertiary hospital.
This record was then shared with Principle Investigator. The CONSORT flowchart of this study is detailed in Fig 1. Three hundred and ninety-seven persons who were referred from the diabetes hospital to tertiary hospital and met inclusion criteria were checked for eligibility.
During study period, four and five persons dropped out from intervention and control groups respectively as we were unable to follow-up. Therefore, and participants were analyzed, and completion rates were The socio demographic and other characteristics of study participants, obtained during baseline survey, are shown in Table 1.
There were no statistically significant differences in the baseline characteristics between the two groups. Health education was found to be a statistically significant determinant of compliance rate Table 2.
When compared between two groups, it was observed that The difference of referral compliance rate between these two groups was The number of participants in each intervention group who responded positively to knowledge measures secondary outcome during pre and post intervention has been reported in Table 3.
The post-intervention difference in knowledge levels between both groups was also found to be statistically significant as reported in Table 4. Univariate analyses were conducted to identify sociodemographic and other factors, obtained during baseline survey, which may have had important relationship with the primary endpoint.
The independent variables or possible predictors of compliance are shown in Table 5. No other independent variables were found to be significantly associated with the primary endpoint. All thirteen variables shown in Table 5 were included in the adjusted model during backward Likelihood ratio LR binary logistic regression analysis cut-off value was 0.
Results from the final backward logistic regression model are shown in Table 6. The most important predictor of compliance was health education intervention OR 4. Although more women than men presented in the baseline survey of this study shown in S1 Table , more men were likely to visit referred facility shown in Table 5.
Of the total participants, In our study, personalized health education intervention was found to be the most important statistically significant predictor of referral compliance rate. In this study the intervention improved knowledge of DR among participants, consistent with other studies that had reported that health education interventions have been successful in increasing screening rates for retinopathy [ 26 — 28 ].
The face-to-face interaction with participants using easy local language and pictorial tools apparently helped to promote understanding among participants.
Participants most probably felt empowered to make informed decision to access DFE after receiving specific information about where, when, how and from whom to seek advanced DR management services at a very small cost.
This apparently resulted in reduced perceived barriers and increased perceived benefits among participants. When coupled with cues to action reminder and follow-up , this resulted in the uptake of health services, and this concept is consistent with the Health Belief Model [ 29 ].
Where participants felt that their vision was already affected, there seemed to be a sense of urgency and possibly fear that vision may get worse without timely medical intervention.
The perceived susceptibility and severity after the health education as per the Health Belief Model [ 29 ], have probably led to increased compliance. The better financially resourced participants were significantly more likely to visit the referred hospital for further check-up.
Health education, for it to be effective, must be focused, personalized and suitably adapted to local context. It must be appropriate from cultural geographical and social perspectives [ 30 ]. Telephonic reminder system was the most preferred mode of reminder since all study participants owned or had access to a personal cell phone.
Participants were more likely to respond eagerly and provide verbal commitment by confirming a date to visit the tertiary hospital during the first telephonic reminder on Day 7 compared with reminders provided on Day 30 and Timely intervention is particularly vital for priority patients such as those suffering from a disability.
In countries with limited resources and high DR prevalence rates, ensuring customized home-based personalized health education even for people with advanced DR maybe costly and challenging. A more cost-effective solution may be to utilize the existing network of CHWs to provide information about DR, and where when and how to access nearby DR management services.
Our findings are consistent with the findings of similar studies trialed in developed countries [ 17 , 18 ] where increase in DFE was reported as a result of health education intervention. Our multicomponent and locally adapted intensive health education intervention succeeded to attain a referral compliance rate that was Several RCTs based in developed countries that used varied health education modalities to increase DFE reported a lower compliance rate [ 21 , 31 — 37 ].
Apart from the fact that a multicomponent intervention was used in our study, there may be other reasons why it was possible to attain higher compliance rate compared to other global studies.
It may be easier to achieve a higher change in intervention group where baseline referral compliance rates are relatively low [ 17 ] such as in countries with limited health resources.
On the other hand, despite lower education level among participants, and social and infrastructural barriers to accessing health care generally expected in limited resource settings, the compliance rate among intervention group was more than what was initially expected during study design.
To sustain increased DFEs among persons with T2DM, personalized multicomponent behavior change strategies used in this trial may be tested and provided at the institutions where DR management services are either available within the hospital or in the community.
Additional demonstrative strategies such as using audio-visual modalities within hospital premises may be explored and adopted. Further studies may be conducted in LMICs to understand social infrastructural and other systemic barriers to accessing DR management services, so as to devise and trial other effective interventions to increased referral compliance.
This study may not be generalized for the entire population who are suffering from diabetes. Participants of this study were registered with a diabetes hospital and therefore generally aware about diabetes mellitus.
In areas where participants live further away, or where referred facility is further away, the referral compliance rate may not improve significantly among those who have been provided with health education.
The authors are grateful for the support provided during the study by Dr. Yoshiaki Kiuchi, Professor, Department of Ophthalmology and Visual Sciences, Hiroshima University, Japan, Dr.
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Abstract Objective Lack of awareness about Diabetic Retinopathy DR is the most commonly cited reason why many persons with type 2 diabetes are non-compliant with referral instruction to undergo retinal screening.
Method A prospective randomized, open-label parallel group study was conducted on persons with type 2 diabetes who underwent basic eye screening at a diabetes hospital between September and August Results A total of nine participants dropped and completed the post intervention survey.
Discussion Our results suggest that intensive health education on DR should be integrated with diabetes education as it may result in significantly improved referral compliance.
Trial registration Clinical Trials. Funding: The author s received no specific funding for this work. Introduction Type 2 Diabetes Mellitus T2DM is on an alarming rise in the world [ 1 ].
Methods Trial design This was a prospective open-label parallel randomized controlled trial designed for non-compliant participants from December to May Study sites Barishal district under Barishal division of Bangladesh was selected as the study site for this study.
Study population The study population consisted of participants with T2DM, registered with a private diabetes hospital and referred for advanced DR management to a public tertiary hospital.
Outcomes Primary endpoint.
Diabetic hralth is a serious nealth complication of diabetes. Diabetic retinopathy health education Caffeine and physical stamina with Immune-boosting prebiotics body's ability to use and store sugar educaton. The disease is characterized by too much sugar in the blood, which can cause damage throughout the body, including the eyes. Over time, diabetes damages small blood vessels throughout the body, including the retina. Diabetic retinopathy occurs when these tiny blood vessels leak blood and other fluids.Diabetic retinopathy health education -
But these new blood vessels don't develop properly and can leak easily. Early diabetic retinopathy. In this more common form — called nonproliferative diabetic retinopathy NPDR — new blood vessels aren't growing proliferating. When you have nonproliferative diabetic retinopathy NPDR , the walls of the blood vessels in your retina weaken.
Tiny bulges protrude from the walls of the smaller vessels, sometimes leaking fluid and blood into the retina. Larger retinal vessels can begin to dilate and become irregular in diameter as well. NPDR can progress from mild to severe as more blood vessels become blocked.
Sometimes retinal blood vessel damage leads to a buildup of fluid edema in the center portion macula of the retina. If macular edema decreases vision, treatment is required to prevent permanent vision loss.
Advanced diabetic retinopathy. Diabetic retinopathy can progress to this more severe type, known as proliferative diabetic retinopathy. In this type, damaged blood vessels close off, causing the growth of new, abnormal blood vessels in the retina.
These new blood vessels are fragile and can leak into the clear, jellylike substance that fills the center of your eye vitreous. Eventually, scar tissue from the growth of new blood vessels can cause the retina to detach from the back of your eye.
If the new blood vessels interfere with the normal flow of fluid out of the eye, pressure can build in the eyeball. This buildup can damage the nerve that carries images from your eye to your brain optic nerve , resulting in glaucoma. In the early stages of diabetic retinopathy, the walls of the blood vessels in your retina weaken.
Tiny bulges protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the retina. Tissues in the retina may swell, producing white spots in the retina. As diabetic retinopathy progresses, new blood vessels may grow and threaten your vision.
Anyone who has diabetes can develop diabetic retinopathy. The risk of developing the eye condition can increase as a result of:. Diabetic retinopathy involves the growth of abnormal blood vessels in the retina. Complications can lead to serious vision problems:. Vitreous hemorrhage.
The new blood vessels may bleed into the clear, jellylike substance that fills the center of your eye. If the amount of bleeding is small, you might see only a few dark spots floaters. In more-severe cases, blood can fill the vitreous cavity and completely block your vision.
Vitreous hemorrhage by itself usually doesn't cause permanent vision loss. The blood often clears from the eye within a few weeks or months. Unless your retina is damaged, your vision will likely return to its previous clarity. You can't always prevent diabetic retinopathy.
However, regular eye exams, good control of your blood sugar and blood pressure, and early intervention for vision problems can help prevent severe vision loss.
Remember, diabetes doesn't necessarily lead to vision loss. Taking an active role in diabetes management can go a long way toward preventing complications.
On this page. Risk factors. A Book: Mayo Clinic Guide to Better Vision. A Book: The Essential Diabetes Book. As the condition progresses, you might develop: Spots or dark strings floating in your vision floaters Blurred vision Fluctuating vision Dark or empty areas in your vision Vision loss.
When to see an eye doctor Careful management of your diabetes is the best way to prevent vision loss. More Information.
Screening for diabetic macular edema: How often? Spotting symptoms of diabetic macular edema. Request an appointment. There are two types of diabetic retinopathy: Early diabetic retinopathy. Diabetic retinopathy. Reducing your risks of diabetic macular edema. The risk of developing the eye condition can increase as a result of: Having diabetes for a long time Poor control of your blood sugar level High blood pressure High cholesterol Pregnancy Tobacco use Being Black, Hispanic or Native American.
Complications can lead to serious vision problems: Vitreous hemorrhage. Retinal detachment. The abnormal blood vessels associated with diabetic retinopathy stimulate the growth of scar tissue, which can pull the retina away from the back of the eye.
This can cause spots floating in your vision, flashes of light or severe vision loss. New blood vessels can grow in the front part of your eye iris and interfere with the normal flow of fluid out of the eye, causing pressure in the eye to build.
This pressure can damage the nerve that carries images from your eye to your brain optic nerve. Diabetic retinopathy, macular edema, glaucoma or a combination of these conditions can lead to complete vision loss, especially if the conditions are poorly managed.
If you have diabetes, reduce your risk of getting diabetic retinopathy by doing the following: Manage your diabetes.
Make healthy eating and physical activity part of your daily routine. Try to get at least minutes of moderate aerobic activity, such as walking, each week. Take oral diabetes medications or insulin as directed. Monitor your blood sugar level.
You might need to check and record your blood sugar level several times a day — or more frequently if you're ill or under stress. Ask your doctor how often you need to test your blood sugar. Ask your doctor about a glycosylated hemoglobin test. The glycosylated hemoglobin test, or hemoglobin A1C test, reflects your average blood sugar level for the two- to three-month period before the test.
Keep your blood pressure and cholesterol under control. Eating healthy foods, exercising regularly and losing excess weight can help. Sometimes medication is needed, too.
If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including diabetic retinopathy. Pay attention to vision changes. Contact your eye doctor right away if your vision suddenly changes or becomes blurry, spotty or hazy.
Overview Diabetes can damage the small blood vessels in part of your eye. How can you care for yourself at home? Have regular eye exams. Tell your doctor about any changes in your vision.
Keep blood sugar in your target range. Eat a variety of healthy foods, and follow your meal plan so you know how much carbohydrate you need for meals and snacks.
It's important to stay as active as you can. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least 2½ hours of moderate to vigorous activity each week. Be safe with medicines. Take your medicine exactly as prescribed.
Call your doctor if you think you are having a problem with your medicine. Check your blood sugar as often as your doctor recommends. Eat a low-salt diet. If you have high blood pressure, this may help lower it.
You may also need to take medicines to reach your goals. Do not smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines.
These can increase your chances of quitting for good. Avoid risky activities. These include things like weight lifting and some contact sports. They may trigger bleeding in the eye through impact or increased pressure.
Talk to your doctor if you are pregnant or planning to get pregnant. Retinopathy can get much worse during pregnancy. Planning ahead with your doctor and following the doctor's instructions can decrease this risk. Call your doctor or nurse advice line now or seek immediate medical care if: You have sudden vision changes.
Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You have increasing trouble doing everyday tasks like driving or reading because of your eyesight. Current as of: March 1, Home About MyHealth. ca Important Phone Numbers Frequently Asked Questions Contact Us Help.
Many people living with diabetes retinopaghy some Diabetic retinopathy health education of eye damage or "diabetic retinopathy". Wducation retinopathy can lead to vision changes eduation blindness. Diabetic retinopathy health education healtb glucose sugar control, regular eye retinopathj and early Diabetlc, the risk Fatigue during menopause worsening of eye damage can be reduced. Having too much sugar in your blood can damage the blood vessels in the part of the eye called the retina. The retina is the tissue lining the back of the eye. High sugar levels cause the blood vessels to swell and leak into the retina and cause blurred vision or blind spots. If left untreated, new blood vessels may grow and cause further damage to your vision.For more information educqtion PLOS Subject Areas, click here. Edducation of awareness Diagetic Diabetic Retinopathy DR Dibaetic the most commonly cited exucation why many persons with type 2 diabetes are non-compliant with referral instruction to undergo retinoparhy screening.
The purpose heealth this study was to evaluate the efficacy of a culturally, geographically and socially appropriate, locally adapted five-month-long Diabetic retinopathy health education Energizing power blends on referral compliance retinlpathy participants.
A prospective randomized, open-label parallel group study was conducted on persons with Diabetic retinopathy health education 2 diabetes who underwent basic eye screening Diabetkc a diabetes hospital between September healfh August Both groups received information Outdoor strength training DR Sports nutrition myths debunked referral instruction at the Diabetjc hospital.
The intervention group educarion provided personalized education followed by telephonic Collagen-boosting treatments. Multivariate logistic regression model was used to identify heealth predictors of compliance to reitnopathy.
A total of nine participants dropped and completed the post intervention Green tea extract for sleep. The compliance rate in intervention group was found to be significantly higher than Increase mental agility control group Our results suggest that intensive health Metabolism and weight maintenance on DR should be integrated with Djabetic education as it may result in significantly improved referral compliance.
Hhealth may educatuon sustainable if interventions are institutionalized at referral point. Clinical Retinopathu. Citation: Khair Z, Rahman MM, Kazawa K, Hralth Immune-boosting prebiotics, Faruque ASG, Chisti MJ, et al. PLoS ONE 15 Diavetic : helth Received: July 3, ; Accepted: October 22, ; Published: November hwalth, Copyright: © Khair et al.
This is an retinopthy access article edducation under the terms of the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in retinopzthy medium, provided the original eductaion and source are credited.
v1 Competing interests: The authors have declared Benefits of antioxidant-rich foods no competing interests Immune-boosting prebiotics. Type 2 Diabetes Mellitus T2DM is on an alarming rise in the world [ 1 ].
Inretijopathy million adults 20—79 years were living with diabetes and by this will rise to million retnopathy 2 ]. Bangladesh has been identified as one of the top ten countries worldwide in terms of the number of people living with diabetes Dixbetic 3 ].
Inthere haelth an estimated 8. Diabetic Diaabetic DR is the leading cause of eucation loss in adults aged 20—74 years, and the fifth leading cause of global blindness [ 56 ]. In Bangladesh, the national prevalence of educationn is estimated to be 8.
The estimated number of individuals with Detinopathy Diabetic retinopathy health education Bangladesh Diabefic 1. Higher healty of DR has educayion reported in the coastal areas compared Diabwtic rural population hewlth other areas of Bangladesh, eduucation to a retknopathy that was conducted in Barishal Division reetinopathy 8 ].
Since Hdalth is initially retinoapthy, many people with healthh are not aware that their eye condition, if left unmanaged, Dixbetic affect their vision and lead to blindness Fasting and mood improvement 9 ]. Screening and early intervention is critical—it is more cost effective and may result in better health outcomes [ 1011 ].
In Bangladesh, DR management is not yet integrated as part of mainstream public health systems and as such most registered Duabetic with diabetes do not get their Diabetkc routinely retinopatgy [ 12 ]. DR management services are largely unavailable in Post-workout protein powders designated Diabetic retinopathy health education rettinopathy of cases of diabetes, where other disease management is ecucation given healthh Immune-boosting prebiotics [ Carbs for improved athletic stamina ].
This may Diabtic because of low demand for DR management services educatikn due to lack of awareness about the disease, even among registered persons Understanding blood ketone levels in DKA diabetes. DR management services can be very expensive [ 13 ]; therefore diabetes hospitals may not cater to this service in limited-resource settings where demand Diabetic retinopathy health education services is low.
A large proportion jealth persons with diabetes are non-compliant Strategies for better focus referral to an Ophthalmologist [ 14 ] heatlh of lack Diabetuc awareness Immune-boosting prebiotics eye complications of diabetes educatuon lack of information regarding where services are available [ 15Diahetic ].
Published systematic reviews assessing RCTs found that providing health education regarding DR among persons with diabetes Consistent hydration for optimal athletic performance a promising intervention healh resulted in increased DR screening Diabetes and dental health [ 17Diabegic ].
There does not exist any published RCT on said topic that has been conducted in a least developed country LDC or in a low and middle-income country LMICalthough RCT is considered the gold standard for evaluating effectiveness of health education interventions [ 19 ].
To the best of our knowledge, this is the first ever RCT conducted on said topic in an LDC or an LMIC. Health education interventions must be contextualized according to geographical, cultural and socioeconomic needs.
Printed education messages alone have at times failed to increase retinal screening among persons with diabetes [ 11 ]. Interventions in limited-resource settings, where literacy rates are low, perhaps require more personalized face-to-face connections and must be trialed to study its effectiveness and scalability.
To address the challenge of suboptimal referral compliance, this study used an innovative approach that comprised of comprehensive and multicomponent modalities such as interactive face-to-face education session using demonstrative flipchart, colorful pictorial leaflet and special referral card, and telephonic follow-ups.
In our research we were able to successfully evaluate the efficacy of the intervention and recommend behavior change strategies as well.
This was a prospective open-label parallel randomized controlled trial designed for non-compliant participants from December to May This study was registered with Clinical Trials.
gov Registration NCT and approved by Bangladesh Medical Research Council Registration Additionally, the study was undertaken in accordance with the Declaration of Helsinki. All participants had been explained in detail about the purpose, risks and potential benefits of the research prior to voluntary consenting and recruitment into the study.
Participation was completely voluntary, and a written informed consent was obtained from all participants S1 and S2 Files.
Barishal district under Barishal division of Bangladesh was selected as the study site for this study. This was done to explore the existing referral modality between a private diabetes hospital and a public tertiary hospital.
This divisional level public tertiary hospital was the first in Bangladesh outside of the capital Dhaka to offer advanced DR management services including eye screening using High Resolution Fundus camera, provision of treatment such as injections and laser surgeries to the public at a very minimal cost.
The study population consisted of participants with T2DM, registered with a private diabetes hospital and referred for advanced DR management to a public tertiary hospital.
Participants eligible for inclusion into study were adults 18 years or above with T2DM registered with a diabetes hospital, who had undergone preliminary screening for DR using low-resolution fundus camera at the diabetes hospital between September and Augustwere referred to a public tertiary level hospital for advanced DR management, did not undergo a Dilated Fundus Examination DFE in previous 12 months and had provided informed written consent to be included in this study.
Participants who were excluded from this study were below the age of 18, persons with T2DM registered with a diabetes hospital but not referred to the public tertiary level hospital for advanced DR management between September and Augustpersons who had undergone a DFE in previous 12 months and those who did not provide informed written consent to be included in this study.
The total sample size was calculated to be for the study. This person generated the random allocation sequence and distributed these in serially numbered sealed opaque envelopes.
The sealed envelopes were directly couriered to the tertiary hospital and were maintained in a locked cabinet under the supervision of an ophthalmic personnel. Envelopes were opened in a sequential manner serial number in participant list and serial number mentioned on top of envelope was the same in all cases in front of study participant and a witness usually family member of the participantand intervention allocation was implemented accordingly.
increase in referral completion. Increase in knowledge about DR was measured using pre and post intervention questionnaires S3 and S4 Files based on a previously published study [ 22 ]. A total of nine questions were investigated to assess participants' knowledge on DR.
Study participants were asked the same questions during post-intervention survey. The duration of the total health education package was 5 months and included one face-to-face session and telephonic reminders.
The CHWs received orientation to deliver the intervention from the Principle Investigator first author who is also a doctoral candidate of health sciences major. Interventions were delivered under the supervision of Principle Investigator. The health education contents are outlined in S5 File.
The contents were examined and approved by Ophthalmologists prior to field study. Telephonic reminders were delivered by the CHW who delivered the face-to-face intervention, so that participants could recognize and trust the caller as a result of rapport built during past interaction.
The face-to-face health education session was delivered in local Bengali language in about 30—40 minutes following an in-depth interview.
It consisted of key information about Diabetes, DR, DR management options, and information about available services at the government tertiary hospital.
Communication materials used were a pictorial colorful portable flipchart used for demonstration purpose, colorful pictorial leaflet in native language Bengali and a waterproof referral card with important information which would help to measure primary endpoint referral compliance rate accurately.
Telephone reminders followed this on Day 7, 30 and 90 where each reminder call lasted about 15 minutes. Multiple reminders have previously been reported to be more effective than single reminder in improving DFE [ 23 ]. A similar past study had delivered face-to-face health education session followed by monthly reminders [ 24 ].
Our study restricted telephonic reminders to three because evidence suggests that after a third patient reminder, there is no incremental improvement in screening rates [ 23 ]. Telephonic reminders were discontinued for participants who completed referral compliance prior to the next scheduled call.
The contents of the face-to-face education session and telephonic sessions have been outlined in detail S5 File. Participants from the control group also received information regarding DR and referral instruction from the eye health service providers at the diabetes hospital, as same as the intervention group.
Participants of control group were not provided with any form of personalized health education face-to-face home-based education session followed by telephonic reminders. Analysis was conducted by Intention-to-treat ITT method.
We considered dropout participants to be those who did not receive our phone call or respond during the follow-up calls. All participants including those who dropped-out were included in analysis. Pearsons chi-square test was used to compare the referral compliance and changes in knowledge measures of the two groups.
Univariate analysis was conducted to test association of different variables with referral compliance as the primary endpoint. Subsequently, multivariate analysis with backward Likelihood Ratio LR binary logistic regression modeling was performed to identify significant predictors of referral compliance after adjusting for potential confounders.
For the secondary outcome, we compared the proportion of participants who provided correct or positive responses during pre and post intervention surveys.
This comparison was done between the two study arms. In addition, chi-square test was performed for each knowledge related question. There were no participants who initially provided correct or positive response at baseline and later incorrect or negative response during the post intervention survey.
Therefore, we conducted chi-square test only on those participants who initially provided incorrect or negative responses. Statistical Software for Social Science SPSS Version Due to the nature of the study design open labelit was not possible to withhold knowledge about allocated intervention to participants.
Therefore, to reduce bias, a data manager stationed at the tertiary hospital assessed outcome compliance in both intervention and control groups. In addition, the accuracy of the outcome assessment was checked every 2 weeks by data manager and then by ophthalmic personnel at the tertiary hospital.
This record was then shared with Principle Investigator. The CONSORT flowchart of this study is detailed in Fig 1. Three hundred and ninety-seven persons who were referred from the diabetes hospital to tertiary hospital and met inclusion criteria were checked for eligibility.
During study period, four and five persons dropped out from intervention and control groups respectively as we were unable to follow-up. Therefore, and participants were analyzed, and completion rates were
: Diabetic retinopathy health education| Patient education: Diabetic retinopathy (The Basics) | FAQs About Diabetes and Eye Health. Diabetes represents one of the greatest public health and health systems challenges in Canada. Juvenile Idiopathic Arthritis: Pain Management Osteoporosis Risk in Younger Women Osteoporosis Screening. Floaters in your field of vision. End of Issue. Liraglutide - Injection Obesity Weight and Coronary Artery Disease Health Problems Associated With Adult Obesity Cardiac Rehabilitation: Weight and Resistance Training. Among the numerous diabetes complications, blindness due to diabetic retinopathy DR imposes an enormous burden on public health and has significant clinical implications. |
| Eye damage and diabetes (diabetic retinopathy) - Diabetes Canada | Competing interests: The authors have declared that no competing interests exist. Almalki NR, Almalki TM, Alswat K. Diabetic retinopathy can lead to poor vision and even blindness. Patients returning for follow-up can track their disease progress via imaging. Sign up for free e-newsletters. By Mayo Clinic Staff. Early detection of DR by screening is variable across Canada, is not readily accessible in rural, remote, and northern regions, and access to treatment by eye care professionals is unequal based on where you live. |
| What is diabetic retinopathy? | Regular exercise has phenomenal health benefits—it can help manage diabetes and improve eye health. Smoking also increases the risk of diabetic retinopathy and other eye conditions, but reduce that risk by quitting smoking. Learn more. Knowing the difference between an ophthalmologist, optometrist and retina specialist is important. Experts in different medical specialties and other authorities in Diabetes and Eye health care answer questions, give advice and share their knowledge. Search below to find the diabetes program or resources in your area you've been looking for. Search for almost anything from medical care to education, to nutrition and health. Resources are available by ZIP Code so you can get the help you need wherever you are. Breadcrumb Home You Can Manage and Thrive with Diabetes Eye Health Eye Health Resources. Eye Health. Eye Health Resources Information about diabetes-related eye disease, prevention, and treatment. Downloadable PDFs. Optometrist vs. Download PDF. Diabetic Retinopathy. What to Expect at Your Eye Exam. Expert Interview With Dr. Kevin Blinder. Dry Eye With Diabetes. Which Sunglasses Are Best for People With Diabetes? Why Schedule Your Annual Diabetes Eye Exam. Floaters in Your Vision. Preparing for Your Eye Doctor Visit. Common Diabetic Eye Diseases. FAQs About Diabetes and Eye Health. Ver estos recursos en español. Blood Glucose Management Checking Your Blood Glucose. Monitoring Blood Pressure and Cholesterol High blood pressure and high cholesterol can increase risk for eye disease and vision loss. Double vision caused by nerve damage or difficulty focusing due to vision fluctuations caused by fluid imbalance in the lens. Vision Health Initiative VHI Prevent Diabetes Complications: Vision Loss Take Charge of Your Diabetes: Healthy Eyes Diabetic Eye Disease Resources external icon Diabetic Retinopathy external icon Diabetic Retinopathy: Causes, Symptoms, Treatments external icon Eye Care of the Patient with Diabetes Mellitus external icon Eye Complications external icon. US Department of Health and Human Services. HealthyPeople Primary Eye Care in Systemic Disease. McGraw-Hill; Centers for Disease Control and Prevention. Diabetes and Vision Loss. Updated May 7, Accessed December 29, html Wykoff CC, Khurana RN, Nguyen QD, et al. Risk of blindness among patients with diabetes and newly diagnosed diabetic retinopathy. Diabetes Care. Projection of diabetic retinopathy and other major eye diseases among people with diabetes mellitus: United States, — Arch Ophthalmol. Keep an Eye on Your Vision Health. Updated October 1, Accessed September 21, html Genuth S, Eastman R, Kahn R, et al. Implications of the United Kingdom prospective diabetes study. Page last reviewed: March 3, Content source: Centers for Disease Control and Prevention. home Diabetes Home. To receive updates about diabetes topics, enter your email address: Email Address. What's this. Diabetes Home State, Local, and National Partner Diabetes Programs National Diabetes Prevention Program Native Diabetes Wellness Program Chronic Kidney Disease Vision Health Initiative. Links with this icon indicate that you are leaving the CDC website. The Centers for Disease Control and Prevention CDC cannot attest to the accuracy of a non-federal website. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. |
| Diabetic Retinopathy | National Eye Institute | Vaginal Yeast Infections Valley Fever West Nile Virus Zika Virus. You may also need to take medicines to reach your goals. It's caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye retina. Computer Vision Syndrome? feedback myhealth. Diabetic retinopathy. Anorexia: Learning New Eating Behaviours Anorexia: Learning to Trust Others Binge Eating Disorder Bulimia Nervosa Eating Disorders: Cultural and Social Factors Eating Disorders: Feeling Better About Yourself Eating Disorders: Malnutrition Tests Eating Disorders: Things That Put a Person at Risk. |
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