Diabetic retinopathy prevalence worldwide,how to care for type 2 diabetes quiz,type 2 diabetes and sugar in urine indicate - PDF 2016


Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. Many more blood vessels are blocked, depriving several areas of the retina with their blood supply.
Millions more have diabetic retinopathy, glaucoma, and other eye conditions that interfere with daily activities – driving, reading, preparing meals.
Bix Saturated fat is one of our best sources for environmental pollutants, a confounder not adjusted for here. Fanatic Cook by Bix is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Objective: To determine the prevalence and causes of blindness and low vision selected population at Tehran province, Iran in 2006. Methods: A population-based cross-sectional study was conducted in the rural and urban population of Tehran province, Iran. Conclusion: The prevalence of blindness and low vision in Tehran province, Iran is similar to other developing countries. Population-based prevalence data are critical for developing eye care programmes and for identifying areas for research.5 The absence of reliable population-based epidemiologic data on blindness and low vision in Iran is a serious problem which affects national planning to reach VISION 2020 goals in Iran. A population-based cross-sectional study was performed in 2006 involving all inhabitants of Tehran province with a total population of 10.5 million.
Trained field interviewers completed the general information section of the questionnaire and visual acuity was obtained by trained optometrists using standardized Snellen E-charts with and without pinhole. Visual impairment, defined by WHO as blindness (BSCVA1 Figures for the developing world, where approximately 90% of world blindness exists, are increasing. This is the first epidemiologic study on blindness and low vision in Tehran province which covered a large population from different age groups applying WHO criteria for visual impairment.
Regarding the above data, it can be concluded that over half of the number of people with visual impairment in Tehran province have a treatable or preventable cause, such as cataract or amblyopia. Central corneal opacities may be due to infectious diseases such as trachoma keratopathy, herpetic keratitis, measles, or scar due to ocular trauma. It seems that good screening and prompt referral of diabetic patients for full-dilated ocular examinations, appropriate treatment and regular follow up examinations may significantly reduce blindness due to diabetic retinopathy. At the second stage of the study, about 24 percent of those who were screened by the optometrists considered having visual impairment did not participate for examination by the ophthalmologists. In conclusion, the prevalence and causes of low vision and blindness in our country is similar to other developing countries and mainly consists of treatable and preventable causes such as cataract and amblyopia due to uncorrected refractive errors that may be significantly decreased by appropriate screening and treatment.
The findings of this study could be useful for the national prevention programmes for blindness and low vision to achieve the VISION 2020 goals as well as the right to sight. This research project has been funded from a grant awarded by the Ministry of Health and Medical Education of I.R. This journal is a member of and subscribes to the principles of the Committee on Publication Ethics. ABCD sponsors treatment for those in need regardless of gender, race or creed, helping them to reach their full potential, to live life with dignity and to take their rightful place in their community. ABCD works through local Palestinian partners, the Bethlehem Arab Society for Rehabilitation (BASR) based in Beit Jala, The Sheepfold in Beit Sahour and two UNWRA Refugee Camps in Jalazone and Nour Shams.
Funding is constantly needed for new projects and to update and refurbish existing facilities. Awareness of eye diseases in an urban population in southern India Rakhi Dandona,1 Lalit Dandona,2 Rajesh K. Large population data analysis provides useful clinical feedback to healthcare providers and national organisations, which aids the wider communication and understanding about changing healthcare demographics.
In 2008, a report by Diabetes UK1 estimated that diabetes accounted for around 10% of NHS expenditure, equating to ?9 billion per year, or ?1 million every hour. This epidemic of diabetes in the UK is mirrored around the world as a result of rising obesity rates and increasing longevity. The Scottish Diabetes Action Plan5 suggests that “Diabetes has been recognised for at least 10 years as an exemplar long-term condition, both in terms of the growing number of people with type 2 diabetes and in terms of the serious and expensive complications it can bring in its train.
In its report “Delivering for Health”, NHS Scotland set out a focus on preventive self-care (promoting wellness), and decreasing costly acute care necessitated by illness events6. The annual Scottish Diabetes Survey (SDS)4 collects quality performance data from all health care trusts in Scotland through the SCI-diabetes diabetes Informatics platforms.
In England, the national diabetes audit serves a similar purpose but suffers from a lack of uniformity in data collection.
Reporting on diabetes prevalence, complication rates and care quality is essential to inform the government, health sector, Non-Government Organisations (NGOs) and the public at large, and allows appropriate resource allocation and policy directive.
What are the Impact and Cost Savings of Better Informed Decisions using Data Reporting for Diabetes Care? In Scotland, the development of a diabetes disease registry (SCI-diabetes) and regular data reporting around quality measures has been widely cited as an example of international best practice. Figure 2A: Incidence of adjusted total amputation with 95% confidence intervals (solid lines) and incidence of adjusted major amputation with 95% confidence intervals (dashed lines) per 1000 patients with diabetes.
This figure was taken from an original paper “Decreasing amputation rates in patients with Diabetes- a population-based study” by Schofield et al10, demonstrating a 40% reduction in diabetes-related amputations between 2000 and 2009- following the introduction of the SCI-diabetes informatics platform. Figure 2B: Contains the amputation and eye laser figures from above combined into one graph. Both graphs show the trends in laser treatment during 2001-2006, for Type 1 and Type 2 diabetes.
The Kuwait Scotland e-Health Innovation Network was formed in 2010 to improve care of chronic disease, with diabetes as an exemplar. Aridhia built an informatics disease registry platform for primary health care clinics in Kuwait. Diabetes care data was collated through KHN and care-mapped against the standard of care dictated by the Kuwait Standard and Clinical Guidelines. Regular semi-automated reports of diabetes prevalence, complication rates and care quality were created on a quarterly basis to inform individual clinics about their performance, in addition to a large annual survey.
In addition to giving population and disease profiling, these reports also allow comparisons between different clinics and against the national averages for care parameters. Here we show further examples of population and disease profiling that is based on anonymised data from the Kuwait Health Network. Disease profile reporting allows healthcare providers to track disease markers over time, and to make comparisons with national standards and guidelines, with other local healthcare providers, and with national averages. Example: HbA1C (a long-term measure of blood sugar control) should be recorded on all patients at around six-monthly intervals. Example plot showing % of patients with HbA1C recorded (within the last 15 months) and the comparison to target. Changes in parameters over time can be mapped using run charts; this is a useful tool for assessing quality improvement. Comparing data with national averages and with other healthcare providers can be useful to determine deficiencies in care provision and allow for appropriate resource allocation, thus improving equity in care.
The following spine chart compares data for Clinic 1 against the national average for a defined list of metrics. The clear display of data in an appropriate format can help readers to quickly assimilate large amount of information.
Aridhia has developed scripts which will automatically calculate the key quality performance indicators (QPIs) for diabetes care using any dataset containing the appropriate fields. Have your blood pressure measured and recorded at least once a year, and set a personal target that is right for you. Have your feet checked – the skin, circulation and nerve supply of your feet should be examined annually.
Receive care planning to meet your individual needs – you live with diabetes every day so you should have a say in every aspect of your care.


Get information and specialist care if you are planning to have a baby as your diabetes control has to be a lot tighter and monitored very closely. Pamela joined Aridhia in 2011, bringing several years' experience in marketing and communications to the company. In fact, African Americans with type 2 diabetes have a greater prevalence and severity of the disease than non-Hispanic whites.
These areas of the retina send signals to the body to grow new blood vessels for nourishment. The study design was based on the World Health Organization (WHO) criteria and a pilot study. The World Health Organization (WHO) estimated that in 2004, 40-45 million people around the world were blind and three times or more had visual impairment, mainly in low-income countries. The study design was based on WHO criteria2 and our previous pilot study preformed in the rural and urban areas in the city of Karaj (a city with 1,160,000 population located 35 kilometers north-west of Tehran). The numerators for the prevalence of low vision or blindness were the sum of weighted cases for each cause of low vision or blindness.
A group of 1,273 subjects (9.6%) were not available for examination or declined to participate in the study and 24% of the population who were screened by the optometrist failed. This discrepancy may be due to the limited nature of the mentioned study which was restricted to the urban population, the desired level of precision and the definition of causes of blindness. Barriers to cataract surgery such as distance, cost, awareness of the benefits of surgery and availability of tertiary ophthalmic facilities need to be identified and strategies implemented to improve access to cataract surgery and promote subsidies for those who cannot afford surgery. To address the need for refractive correction, the number of screening centers in both rural and urban areas should be increased. The vast majority of them can be prevented or treated with appropriate prophylactic or therapeutic measures. Design and program for determination of prevalence and causes of severe visual impairment and blindness in Tehran province 2004-2005. Prevalence and causes of blindness and visual impairment in Bangladeshi adults: results of the National Blindness and Low Vision Survey of Bangladesh.
Prevalence of blindness and low vision in Malaysian population: results from the National eye survey 1996. Prevalence and causes of visual impairment and blindness among 9980 Scandinavian adults: The Copenhagen City Eye Study.
Prevalence of blindness and low vision in an Italian population: a comparison with other European studies. Impact of bilateral visual impairment on health-related quality of life: the Blue Mountains Eye Study. Prevalence of vitreoretinal disorders in a rural population of Southern India: the Aravind Comprehensive Eye Study. Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study.
The data are of particular importance because we recently found that 1% of the population studied was blind (7), while a further 7.2% had moderate visual impairment (8). A focus on risk-factor profiling enables early preventive care strategies, reducing subsequent complications and costly hospital admissions. This was double a 2001 estimate (Department of Health, 2001)2, showing the impact of a rising prevalence across the UK. Many countries with rapidly emerging economies such as China, South East Asia, South America and Africa will see the most dramatic rises in diabetes rates over the next few decades, as wealth generation leads to adoption of more sedentary behaviour and poorer, high-fat, Western-style diets. Maintaining and improving the quality of diabetes services against a backdrop of increased incidence and prevalence, and the consequent pressure on those services, forms a key challenge facing NHS Scotland”. This national annual report informs the diabetes community about care quality and drives care improvements …. General Practitioners are financially rewarded for achieving targets relating to care quality.
SCI-diabetes, which started as a research database in NHS Tayside, has been rolled out and developed throughout Scotland. Incidence of adjusted total amputations with 95% confidence intervals (solid lines) and incidence of adjusted major amputations with 95% confidence intervals (dashed lines) per 1000 patients with diabetes.
Kuwait’s adult population has the sixth highest prevalence of diabetes in the world, affecting approximately 24% of the population. The Kuwait Health Network (KHN) informatics platform was piloted in four primary health care clinics in Kuwait capital region. These reports were also be used by Ministry of Health and wider national bodies to decide on care priorities and resource allocation. The dotted line represents the median based on the most recent 15 data points for each chart. The red dots show where it is doing worse than the national average; the green dots show where it is doing better than the national average. An HbA1c blood test will measure your overall blood glucose control and help you and your diabetes healthcare team set your own target. Like blood glucose levels and blood pressure, you should have your own target that is realistic and achievable. Using a specialised digital camera, a photo of each eye will be taken and examined by a specialist who will look for any changes to your retina (the seeing part at the back of your eye). You should be told if you have any risk of foot problems, how serious they are and if you will be referred to a specialist podiatrist or specialist foot clinic.
You should have two tests for your kidneys: urine test for protein (a sign of possible kidney problems) and a blood test to measure kidney function. Your yearly care plan should be agreed as a result of a discussion between you and your diabetes healthcare team, where you talk about your individual needs and set targets. If you have to stay in hospital, you should still continue to receive high-quality diabetes care from specialist diabetes healthcare professionals, regardless of whether you have been admitted due to your diabetes or not. You should expect care and support from specialist healthcare professionals at every stage from preconception to post-natal care. Diabetes affects different parts of the body and you should have the opportunity to see specialist professionals such as an ophthalmologist, podiatrist or dietician.
Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. She has been involved in some of Aridhia’s highest profile projects, including DECIPHER Health and the launch of AnalytiXagility, and is a valued member of the commercial team. Multi-stage cluster random sampling method was used and sample size was calculated based on the distribution of population in Tehran province derived from the national census and estimated rate of blindness from the pilot study.
The study implemented multi-stage cluster random sampling which included 138 randomly allocated clusters (118 urban and 20 rural, with 21 to 23 households in each cluster). Age-standardized data were used to estimate the number of people with low vision, blindness, causes of visual loss and the prevalence for the entire population of Tehran province in 2005.
Comparison for distribution of age and residential area between subjects in this study and the total population derived from the national census showed no significant difference. Adequate correction of refractive errors may lead to marked improvement in visual function and quality of life.
The majority of our cases had age related macular degeneration, retinal detachment and retinal vascular accidents. Prevalence and causes of visual impairment and blindness in the south western region of Saudi Arabia. In many Middle Eastern countries, around 1 in 5 of the population already has diabetes (see later example).
Timely analytic reporting could help support this and many of the other priorities of this plan – particularly those around patient safety, complication prevention, and emergency admission reduction through early risk stratification and a system to monitor quality improvement.
Regular monitoring of diabetes care targets for this purpose is therefore essential for individual practices, primary care collectives and commissioning bodies.


Schofield et al12 demonstrated a reduction in diabetes amputation, and Vallance et al13 a reduction of retinopathy requiring laser treatment over the period of informatics implementation and data usage (Figures 2 and 3). The generation of these reports can be as frequent as data is refreshed, for example, daily or as required for team meetings, through to national reports (weekly, monthly, quarterly, yearly as required). When the time comes to leave paediatric care, you should know exactly what to expect so you have a smooth change over to adult health services. You should be able to talk about your issues and concerns with specialist healthcare professionals. Pamela likes to make simple messages out of complicated concepts and works closely with the entire Aridhia team, collaborative partners, products, and perceptions to build relationships, brands and marketing strategies. Information was collected using a questionnaire filled after screening by optometrists and referral examinations by ophthalmologists.
Epidemiologic studies on the prevalence and causes of blindness and low vision started in 1995 and expanded to many developed and developing countries. Sample size was calculated based on the distribution of the total population in Tehran province derived from the national census and an estimated rate of blindness derived from our pilot study. Main causes of blindness and low vision were determined and categorized based on ICD-10 criteria by ophthalmologists. However, male subjects were under-represented in the sample in comparison to the target population. Even in this category there are preventable and treatable underlying causes such as systemic hypertension.
The prevalent national diabetes population of Scotland has increased from 103,835 (2%) in 2002 to 258,570 in 2012, representing 5% of the Scottish population (Scottish Diabetes Survey)4. This has the potential to translate into massive long-term cost savings for the NHS through the prevention of costly hospital admissions and complications care. Categorization of blindness and low vision was based on the International Classification of Diseases version 10 (ICD-10).
This study was conducted in a representative sample to determine the prevalence and causes of blindness and low vision in Tehran province, Iran.
Data were obtained from rural and urban health centers by completing a questionnaire including general information, results of optometrists' and ophthalmologists' examinations and the main cause of visual impairment. More details on methods and implementation of study design have been published elsewhere.7 The center of disease control (CDC) in Iran approved this survey regarding methodology and ethical consideration.
This is important because in the same population all cases of blindness were in people > 30 years of age (7). There was a significant positive correlation with age (PTable-1 shows the prevalence of different types of blindness by age and gender.
As expected, education played a significant role in the awareness of these eye diseases. Of these subjects, 1859 aged >15 years responded to a structured questionnaire on cataract, glaucoma, night blindness and diabetic retinopathy to trained field investigators. The prevalence of bilateral low vision increased with older age (PTable-2 shows the prevalence of different types of low vision by age group and gender. Subjects aged > 30 years were significantly more aware of all eye diseases assessed except night blindness. Such awareness and knowledge could lead to better understanding and acceptance of the importance of routine eye examinations for the early detection and treatment of eye diseases, thereby reducing visual impairment in this population.
Two studies in Australia found a reasonable level of awareness of glaucoma but poor knowledge of the condition (2, 3). Hence, an increase in the level of awareness of glaucoma in our population is essential if more people are to be screened for the condition. A majority (65%) of the subjects reported other causes (consanguineous marriage, congenital defects and heredity) as common causes of night blindness even though the question asked was specifically about night blindness in childhood, which is most commonly due to vitamin A deficiency in the developing world. We assessed the level of awareness of common eye diseases in the urban population of Hyderabad in southern India in the population-based Andhra Pradesh Eye Disease Study (APEDS) (6). This population has recently been reported also to have a high prevalence of blindness (7) and moderate visual impairment (8). Vitamin A deficiency is reported to be largely confined to impoverished countries, neighbourhoods and families (14).
The detailed methodology used in the study has been reported elsewhere (6–8), but briefly the sample size was determined based on the eye diseases of interest with the least assumed prevalence, and the power to detect odds ratios for risk factors (6). Those belonging to the extreme lower and lower socioeconomic strata were significantly less aware of night blindness, and they are more likely to have children with vitamin A deficiency.
Based on an expected recruitment rate of 85%, we selected 2954 subjects representative of the population of Hyderabad for the urban segment of APEDS in Hyderabad city using a multistage sampling procedure (6, 7).
The blocks (clusters) in Hyderabad were stratified by socioeconomic status and religion (6, 7).
Awareness of night blindness and vitamin A deficiency per se clearly has to be increased among those groups that are likely to be more susceptible to vitamin A deficiency. Women were less aware of night blindness and, since in the study population they are more often responsible for the family diet, particularly that of children, they must be targeted to increase their awareness of night blindness and vitamin A deficiency. Subjects belonging to the upper and middle socioeconomic strata were more likely to be aware of this. Data from the urban segment of APEDS were collected in Hyderabad from October 1996 to June 1997. This may have been because these strata had better access to medical and diagnostic care. This is particularly important in a developing country such as India, with considerable investment in tertiary eye care. These data are for an urban population and based on these findings we would expect that awareness and knowledge of eye diseases would be worse in rural India. Increasing the awareness and knowledge of common eye diseases could lead to an increase in understanding and acceptance of the importance of routine eye examination for early detection and treatment of such conditions, thereby reducing visual impairment and cost of eye care.
The eye diseases for which awareness was assessed were as follows: cataract, glaucoma, night blindness and diabetic retinopathy.
These data could help to develop effective health education and information programmes to reduce visual impairment among the study population.
The questionnaire was initially developed in English and all the questions were then translated into the two most common local languages, Telugu and Hindi, using a pragmatic approach to adapt the questionnaire for use in the target population. Terms used in the local languages for the eye diseases assessed were identified from eye-care personnel, patient counsellors and patients at the L.V.
Further questions on that particular disease were asked only if the subject responded positively.
The response given by the subject was documented fully if it did not correlate with any of the responses listed on the questionnaire.
The demographic associations of awareness and knowledge of all the eye diseases with age, gender, education, socioeconomic status and religion were assessed by univariate analyses followed by multiple logistic regression. The effect of each category of a multicategorical variable was assessed by keeping the first or the last category as the reference.
The estimates were adjusted for the age and gender distribution of the Hyderabad population (9). Based on the rates in each cluster, the design effect of the sampling strategy was calculated for the estimates (10), and the 95% confidence intervals (CI) adjusted accordingly. Data were missing for 16 of the subjects and the present article therefore presents the results of the analysis of the replies for 1843 of them.



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Comments

  1. Bakinocka

    They restrict their carb i'd.

    22.03.2014

  2. AntikilleR

    And desserts, all based mostly on low maintain good glucose control for 3 - 6 months before.

    22.03.2014