Overview
The increasing incidence of diabetes mellitus (DM) worldwide and higher life expectancy of the elderly populations has resulted to an increment in microvascular complications such as diabetic retinopathy. Diabetic retinopathy (DR) is a major cause of visual impairment globally and constitutes an important social and financial burden. Visual impairment, patients worries about chronicity of DM and DR and restrictions due to DM and DR can affect their quality of life (QoL) and cause psychological and environmental-social problems. We do not know the QoL our DM patients are living with.
Principal Investigator
Abstract
The increasing incidence of diabetes mellitus (DM) worldwide and higher life expectancy of the elderly populations has resulted to an increment in microvascular complications such as diabetic retinopathy. Diabetic retinopathy (DR) is a major cause of visual impairment globally and constitutes an important social and financial burden. Visual impairment, patients worries about chronicity of DM and DR and restrictions due to DM and DR can affect their quality of life (QoL) and cause psychological and environmental-social problems. We do not know the QoL our DM patients are living with \DM. Objective: Our main objective will be to describe the Vision-related quality of life (VRQoL) among participants with DM attending the diabetes medical and diabetes retina clinics at Kenyatta National Hospital (KNH). We would compare the VRQoL of those with DR and those without. We would also assess whether there is a trend of worse VRQoL with increasing severity of DR. Design: Hospital-based analytical cross-sectional study. Study Location: KNH Diabetes and Endocrinology Center of Excellence (Medical) and Diabetes Retina Clinics in the eye clinic no.35. Methods: VRQoL will be assessed using the WHO/PBD VF-20 questionnaire, a standard tool that has been validated in previous studies in Kenya. At least 90 participants will be enrolled; 45 without DR and 45 with DR. The inclusion criteria will be participants aged 18 years and older with at least five years of follow-up for diabetes mellitus in KNH. Diabetic patients without DR will be recruited from the Diabetes Medical Clinics.Diabetics with DR will be recruited from the Diabetes Retina Clinic.For all those who consent to participate, their sociodemographic details, medical, ocular history will be obtained.In the Diabetes Medical Clinic, fundus photographs will be done for all diabetic patients and those with no retinopathy-associated changes will have the WHO/PBD VF-20 questionnaire administered there. Those with any retinopathy seen on fundus photography will be referred to the Diabetes Retina Clinic for assessment by a Vitreo-retinal specialist. We shall also record the grading of diabetic retinopathy for both eyes using the Early Treatment Diabetic Retinopathy Study (ETDRS) system, checkfor the presence of DME, and then proceed to administer the WHO/PBD VF-20 questionnaire in those with DR. Comparison of the mean VRQoL scores for DR and non-DR patients will be done using the Student t-test. All tests will be done at the 95% confidence level. Significance of the study: Understanding the VRQoL of diabetic patients in KNH would form an initial evaluation of their QoL health status and may guide any further care provision required. We anticipate that QoL evaluations would become part of routine assessment of DM and DR patients.
