Publication: The proportion and factors associated with diabetic retinopathy among type 2 diabetes mellitus patients in Perak from 2018-2022
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Date
2025-06
Authors
Mithra, Yogeswary Mithra A/P Nandi
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Abstract
Introduction: Diabetic retinopathy (DR) remains a leading and preventable cause of vision loss among individuals with Type 2 Diabetes Mellitus (T2DM), posing a significant public health challenge both globally and in Malaysia. In Perak, the increasing burden of diabetes underscores the need for local data to inform targeted screening and management strategies. This study aimed to determine the proportion and identify factors associated with DR among T2DM patients in Perak between 2018 and 2022.
Methodology: A cross-sectional study design was employed using secondary data from the National Diabetes Registry (NDR) of Perak. Adults aged 18 years and above with Type 2 Diabetes Mellitus diagnosed between January 2018 and December 2022 were included. After applying inclusion and exclusion criteria, 1160 patients were selected via simple random sampling. Data on sociodemographic characteristics, clinical parameters, comorbidities and treatment details were extracted and analysed using SPSS version 29. Simple and multiple logistic regression analyses were conducted to identify independent factors associated with Diabetic Retinopathy.
Results: Among the 1160 Type 2 Diabetes Mellitus patients sampled, the overall proportion of Diabetic Retinopathy was 25.4%. Notably, there was a declining trend in Diabetic Retinopathy proportion from 31.4% in 2018 to 13.8% in 2022. The mean age of patients was 55.3 years and 59.0% were female. Multivariable logistic regression identified several independent risk factors for Diabetic Retinopathy which includes increasing age (Adj OR 1.04; 95% CI: 1.02, 1.05), longer duration of diabetes (Adj OR 1.20, 95% CI: 1.07, 1.35), poor HbA1c control (Adj OR 1.10, 95% CI: 1.01, 1.19), nephropathy (Adj OR 4.54, 95% CI: 2.88, 7.24), hypertension (Adj OR 1.72; 95%CI 1.21, 2.47) and insulin therapy (Adj OR 2.5; 95% CI 1.66, 3.77). The findings are consistent with both local and international literature, reinforcing the importance of these modifiable and non-modifiable risk factors
Conclusion: The study reveals a significant reduction in Diabetic Retinopathy prevalence among Type 2 Diabetic Mellitus patients in Perak, reflecting improvements in diabetes management, regular retinal screening and public health interventions. However, the persistence of traditional risk factors highlights the ongoing need for integrated and multidisciplinary care, regular screening and prioritisation of high-risk individuals. The findings support the strengthening of preventive strategies and resource allocation to further reduce the burden of vision-threatening diabetic complications in Perak and similar settings
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Keywords
diabetic retinopathy , type 2 diabetes Mellitus