Background
Methods
Study setting and study population
Study instrument
Measures
Statistical analysis
Ethical considerations
Results
Characteristics of participants
Al a
| Type 1 | Type 2 | |
---|---|---|---|
(n= 323) | (n = 44) | (n = 269) | |
Mean (SD) age (years) | 66.5 (10.6) | 57.4 (14.0) | 68.1 (9.3) |
Women | 38.7% | 63.6% | 34.9% |
Nationality | |||
Swiss | 83.5% | 74.4% | 85.9% |
Other | 16.5% | 25.6% | 14.1% |
Education | |||
Primary | 16.0% | 14.3% | 15.4% |
Secondary | 57.6% | 54.8% | 59.0% |
Tertiary | 26.4% | 31.0% | 25.6% |
Married or living with partner | 65.9% | 56.8% | 66.5% |
Economic hardships | |||
Difficulties in paying bills during the past 12 months | 22.8% | 34.1% | 20.3% |
Health insurance subsidies | 17.3% | 20.5% | 16.7% |
Member of the local diabetes associationb
| 18.3% | 54.6% | 12.7% |
Current smoking | 18.4% | 14.0% | 19.6% |
Physically inactive | 31.0% | 29.6% | 32.0% |
Type of diabetes | |||
Type 1 | 13.6% | - | - |
Type 2 | 83.3% | - | - |
Undetermined | 3.1% | - | - |
Type of treatment | |||
Oral antidiabetics | 42.6% | 0.0% | 50.8% |
Insulin or other antidiabetic injection | 57.5% | 100% | 49.3% |
Self-reported health | |||
Excellent/very good | 14.9% | 21.4% | 14.4% |
Good | 61.3% | 64.3% | 60.6% |
Medium/poor | 23.8% | 14.3% | 25.0% |
Prevalence of eye conditions
Alla
| Type 1 | Type 2 | ||
---|---|---|---|---|
(n = 323) | (n = 44) | (n = 269) | ||
% | [CI 95%] | % | % | |
Eye diseases b (n = 318) | (n = 318) | (n = 44) | (n = 265) | |
Diabetic retinopathy | 14.2% | [10.3%–18.0%] | 40.9% | 9.8% |
Cataract | 35.8% | [30.5%–41.1%] | 40.9% | 35.1% |
Glaucoma | 12.6% | [8.9%–16.2%] | 11.4% | 12.8% |
Age-related macular degeneration | 4.7% | [2.4%–7.1%] | 4.5% | 4.5% |
Myopia, hyperopia, astigmatism, presbyopia | 36.2% | [30.9%–41.5%] | 38.6% | 35.5% |
Other | 2.8% | [1.0%–4.7%] | 2.3% | 3.0% |
No | 26.7% | [21.8%–31.6%] | 22.7% | 27.9% |
Do not know | 2.5% | [0.8%–4.2%] | 2.3% | 2.6% |
Number of eye diseases reported (n = 310) | (n = 310) | (n = 43) | (n = 258) | |
0 disease | 27.4% | - | 23.3% | 28.7% |
1 disease | 45.8% | - | 37.2% | 46.5% |
2 diseases | 20.0% | - | 18.6% | 20.2% |
≥ 3 diseases | 6.8% | - | 20.9% | 4.7% |
Treatment for diabetic retinopathy (among patients reporting diabetic retinopathy) b (n = 41) |
n = 41) |
n = 15) | (n = 25) | |
Laser therapy | 75.6% | [61.9%–89.3%] | 100.0% | 60.0% |
Eye injection | 26.8% | [12.7%–41.0%] | 33.3% | 24.0% |
Surgical intervention | 19.5% | [6.8%–32.2%] | 26.7% | 16.0% |
Other | 2.4% | [−2.5%–7.4%] | 0.0% | 4.0% |
Retinopathy without having had treatment | 9.8% | [0.3%–19.2%] | 0.0% | 16.0% |
Do not know | 2.4% | [−2.5%–7.4%] | 0.0% | 4.0% |
Awareness regarding diabetic eye diseases
(n) | Expected answer | % of correct answers | |
---|---|---|---|
Prevention meansa
| |||
Maintaining good glycemic control | (291) | Yes | 98.6% |
Having regular eye examination by an ophthalmologist | (284) | Yes | 97.5% |
Maintaining good blood pressure control | (288) | Yes | 91.3% |
Maintaining good lipid control | (274) | Yes | 85.4% |
Nothing can be done, it is “bad luck” | (236) | No | 75.9% |
Mean knowledge score [95%CI]b
| (292) | 4.1 [4.0–4.2] |
Practices: Frequency of eye examination
Visit to an ophthalmologist during the past 2 years | Yes (n = 280) | No (n = 42) | ||
---|---|---|---|---|
n
| Mean (SD) or % | Mean or % |
p-valuea
| |
Age | 322 | 66.8 (10.5) | 64.7 (11.5) | 0.244 |
Gender | 322 | |||
Women | 40.0% | 31.0% | 0.262 | |
Men | 60.0% | 69.1% | ||
Education | 317 | |||
Primary | 14.9% | 23.8% | 0.172 | |
Secondary | 59.6% | 45.2% | ||
Tertiary | 25.5% | 31.0% | ||
Type of diabetes c
| 322 | |||
Type 1 | 15.0% | 4.8% | 0.153c
| |
Type 2 | 81.8% | 92.9% | ||
Undetermined | 3.2% | 2.4% | ||
Type of treatment | 321 | |||
Oral antidiabetic | 37.9% | 73.2% | <0.001 | |
Insulin or other antidiabetic injection | 62.1% | 26.8% | ||
Member of the local diabetes association | 321 | 20.1% | 7.1% | 0.053 c
|
Number of eye diseases reported | 310 | 1.2 (1.0) | 0.6 (0.6) | 0.001 |
HbA1C valueb
| 174 | 7.3 (1.1) | 6.8 (0.8) | 0.313 |
ADDQoL global score | 322 | −1.5 (1.6) | −0.8 (1.1) | 0.011 |
SF-12 PCS | 312 | 43.5 (10.0) | 44.8 (9.6) | 0.440 |
SF-12 MCS | 311 | 46.4 (11.1) | 45.9 (10.2) | 0.771 |
PACIC global score | 316 | 2.8 (1.0) | 2.2 (0.8) | <0.001 |
Stanford self-efficacy score | 316 | 7.8 (1.6) | 7.6 (1.9) | 0.610 |
HbA1C awareness | 303 | 91.3% | 66.7% | <0.001 |
HbA1C checkb
| 262 | 99.2% | 92.0% | 0.047 c
|
Blood pressure measurement | 315 | 99.3% | 95.2% | 0.087 c
|
Lipid profile | 311 | 97.4% | 95.2% | 0.349 c
|
Diabetic foot examination | 313 | 68.6% | 45.2% | 0.003 |
Microalbuminuria test | 283 | 82.9% | 71.1% | 0.083 |
Influenza vaccination | 314 | 67.7% | 45.2% | 0.005 |
Barriers and facilitators to regular eye examination
% | [CI 95%] | |
---|---|---|
Facilitatorsb
| (n = 305) | |
Recommendation of healthcare professionals | 54.8% | [49.1%–60.4%] |
Recommendation of relatives | 2.3% | [0.6%–4.0%] |
Feeling obliged to do it | 9.8% | [6.5%–13.2%] |
Knowledge of its importance | 38.0% | [32.6%–43.5%] |
Knowledge of the risks of a diabetes-related affection of the retina | 33.8% | [28.4%–39.1%] |
Knowledge of the treatment options | 11.8% | [8.2%–15.4%] |
Fear of having their eyes affected | 22.3% | [17.6%–27.0%] |
Having another eye problem necessitating an ophthalmologic follow-up | 14.4% | [10.5%–18.4%] |
Barriersc
| (n = 70) | |
No recommendation from the family physician or diabetologist | 30.0% | [19.0%–41.0%] |
No information about diabetic eye diseases | 7.1% | [1.0%–13.3%] |
No information about retinal screening | 2.9% | [−1.1%–6.9%] |
No time | 10.0% | [2.8%–17.2%] |
Financial reasons | 4.3% | [−0.6%–9.1%] |
Too many other examinations and medical appointments | 4.3% | [−0.6%–9.1%] |
Fear of the examination, result or treatment | 1.4% | [−1.4%–4.3%] |
Fear of losing their driving license | 0.0% | - |
Discomfort during the examination (eye drops, dilated pupils) | 1.4% | [−1.4%–4.3%] |
Difficulty to find an ophthalmologist | 4.3% | [−0.6%–9.1%] |
Difficulty to go to the ophthalmologist’s practice | 4.3% | [−0.6%–9.1%] |
No symptoms or vision problems | 32.9% | [21.6%–44.1%] |
Belief that it is not necessary because diabetes is well controlled | 30.0% | [19.0%–41.0%] |