The relationship between diabetic retinopathy and nephropathy in Sudanese adult with diabetes: population based study.

INTRODUCTION: Diabetic nephropathy is responsible for nearly third of the world cases of end stage renal disease; it becomes a major public health problem with social and economic burden. The aim of this study is to explore if there is an association between retinopathy and nephropathy. MATERIAL AND METHODS: In a cross sectional hospital based study a total of 316 individuals with diabetes were recruited from Makkah eye complex retina clinic. Demographic data, medical history and life style characteristics were taken through standard questionnaire. In addition, urine samples were collected to check for presence of albuminuria, blood samples were taken to measure HbA1c, lipid profile and renal function test. RESULTS: The mean age of participants was 58±10 years old. Only 39.8 and 40.2% of females were diagnosed with retinopathy and nephropathy, respectively. In addition, 60.2 and 59.8% of males were diagnosed with retinopathy and nephropathy, respectively. Hypertension was identified as risk factors for both retinopathy and nephropathy (P<0.001 and P<0.07). Serum creatinine and blood urea are significantly associated with retinopathy (P<0.01 and P<0.01). Body mass index (BMI) and HbA1c are not significantly associated with retinopathy and nephropathy. The prevalence of nephropathy among individuals with retinopathy was 35.6%. There was significant association between nephropathy and development of retinopathy (P<0.01). Logistic regression showed that two absolute risk factors are: nephropathy and having hypertension with P value of 0.009 and 0.003, respectively. CONCLUSIONS: Almost third of diabetic patients developed nephropathy, significant association between nephropathy and development of retinopathy was found.

Frequency of diabetic retinopathy and associated risk factors in Khartoum, Sudan: population based study.

AIM: To assess the frequency and associated risk factors of diabetic retinopathy among Sudanese individuals with diabetes attending Makka Eye complex in Khartoum, Sudan. METHODS: The cross sectional hospital based study recruited 316 individuals with diabetes from Makkah Eye Complex Retina Clinic. Standard questionnaire was used to collect demographic data, medical history and life style characteristics. Blood samples were taken to measure HbA1c and lipid profile. Fundus and slit lamp examination were performed for screening of diabetic retinopathy. RESULTS: Among 316 participants, 187 (59.2%) were males and 129 (40.8%) were females. The mean age of participants was 58.7±10.5y. The overall frequency of retinopathy was 261 (82.6%). The percentages of the total participants with proliferative diabetic retinopathy (PDR) were 126 (39.9%) and non-proliferative diabetic retinopathy (NPDR) were 135 (42.7%). Importantly, duration of diabetes mellitus (DM) (72.2% of more than 10y), being on oral hypoglycaemic drugs (versus insulin), and hypertension were all significant risk factors for diabetic retinopathy (P=0.00, 0.01 and 0.00 respectively). Complications of diabetes like diabetic foot (17.7%), history of amputation (6.7%) and clinically significant macular edema (CSME) (47.4%) of the eyes were all significant risk factors (P<0.05). Logistic regression analysis showed that duration of diabetes, hypertension and CSME were found to be absolute risk factors (P=0.007, 0.003 and 0.000 respectively). Duration of DM of more than 10y have more than double risk (OR=2.8), while having hypertension triples the risk of retinopathy (OR=3.1). CONCLUSION: High rates of diabetic retinopathy are noted among individuals with diabetes attending Makkah Eye hospital in capital Khartoum. Urgent strategies are needed to monitor and treat hypertension and optimize diabetes control in individuals with diabetes. More investment in diabetes services is urgently needed.

Metabolic control targets in Sudanese adults with type 1 diabetes: A population-based study.

BACKGROUND: Type 1 diabetes is a challenging metabolic disorder for health authorities in Sudan. The objective of this study was to assess the level of glycemic control and to determine the prevalence of dyslipidemia and complications among individuals with type 1 diabetes in Sudan. MATERIALS AND METHODS: Individuals with type 1 diabetes, who were having the disease for at least 1 year, were invited to participate in this study. Data were collected from two diabetes centers, in the Capital Khartoum and Atbara City, North of Sudan. Participants were interviewed using standardized pretested questionnaire to record medical history, sociodemographic data, and life style characteristics. Blood pressure, body mass index, and waist circumference were measured. Blood samples were taken for measurement of lipid profile and glycosylated hemoglobin. RESULTS: A total of eighty individuals with type 1 diabetes volunteered to participate in this study, 37.5% of males and 62.5% of females. Majority of the patients were aged between 40 and 70 years old. There was poor glycemic control (glycosylated hemoglobin >7%), in 83.8%. Age and sex were significant factors associated with poor glycemic control in this cohort. High cholesterol, triglyceride, and low density lipoprotein were seen in 76.2%, 27.5%, and 48.8% of participants, respectively. Low high density lipoprotein was seen in 33.8%. Hypertension was determined in 21.3%. Peripheral neuropathy, visual impairment, diabetic foot, and myocardial infarction were seen in 50%, 48.8%, 18.8%, and 2.5% of patients, respectively. CONCLUSION: Sudanese adults with type 1 diabetes have poor glycemic control, high prevalence of dyslipidemia, and long-term complications.

Glycaemic control in Sudanese individuals with type 2 diabetes: Population based study.

BACKGROUND: Diabetes mellitus (DM) is a major health problem in Sudan and is a leading cause of morbidity and mortality. The objective of this study was to determine the prevalence of glycaemic control among individuals with type 2 diabetes across different cities in Sudan. METHODS: Individuals with type 2 diabetes attending selected diabetes centres in Sudan, who had been on treatment for DM for at least one year and volunteered to participate were included. Participants were interviewed using standardized pretested questionnaire to record medical history, sociodemographic and life style characteristics. Lipid profile and glycosylated hemoglobin were tested by calibrated laboratory methods. Blood pressure, Body mass index (BMI) and waist circumference were measured. Chi squared and logistic regression were used as statistical methods. RESULTS: A total of 387 individuals with T2DM were included in this study (50.4% males and 49.6% females). The glycemic control indicator (HbAIc>7) was poor in 85% of patients. Factors associated with poor glycemic control were prolonged duration of diabetes (p=0.03), high plasma triglyceride (p=0.02), low high density lipoprotein (HDL) level (p=0.04) and low glomerular filtration rate (GFR) (P=0.01). Logistic regression analysis showed that low GFR is independent factor with poor diabetes control. CONCLUSION: High prevalence of uncontrolled diabetes (85%) is noted in Sudanese individuals with type 2 diabetes.