An estimation of the prevalence of diabetes mellitus and diabetic retinopathy in adults in Timor-Leste

BMC Research Notes

Mark Shephard⁵  Nitin Verma²  Lara Alexandra Motta⁵  Julia Magno⁴  Bernadete Pereira⁴  Belmerio Jeronimo³  Basilio Martins Pinto³  Manoj Sharma¹  Genevieve Frances Oliver³  Rosie Claire Hewitt Dawkins¹ 

[1]Timor-Leste Eye Program, Royal Australasian College of Surgeons, Melbourne, Australia

[2]School of Medicine, Sydney University, Sydney, Australia

[3]Fred Hollows Foundation of New Zealand, Auckland, New Zealand

[4]Sentru Matan Nasional, Hospital Nacional Guido Valadares, Bidau, Dili, Timor-Leste

[5]Flinders University International Centre for Point-of-Care Testing, Flinders University, Adelaide, Australia

关键词: Cataract;    HbA1c;    Point-of-care testing;    Diabetic retinopathy;    Diabetes mellitus;    East Timor;    Timor-Leste;   

Others  :  1231944
DOI  :  10.1186/s13104-015-1171-3

 received in 2015-01-07, accepted in 2015-05-13,  发布年份 2015

【 摘 要 】

Background

Once considered an affliction of people in high-income countries, diabetes mellitus is increasingly seen as a global epidemic. However, for many countries very little is known about the prevalence of diabetes and its complications. This study aims to estimate the prevalence of diabetes, and diabetic retinopathy, in adults in Timor-Leste.

Methods

From March 2013 to May 2014, adult patients being assessed for cataract surgery at the Sentru Matan Nasional (National Eye Centre) in Dili, Timor-Leste had a point-of-care HbA1c measurement performed on the DCA Vantage device (Siemens Ltd) under a quality framework. A diagnostic cut-off of 6.5% (48 mmol/mol) HbA1c was used for diagnosis of diabetes. Ocular examination, blood pressure, demographic and general health data were also collected. Diabetic retinopathy assessment was carried out by ophthalmologists.

Results

A total of 283 people [mean age 63.6 years (range 20–90 years)] were tested and examined during the study period. Forty-three people (15.2%) were found to have diabetes, with a mean HbA1c of 9.5% (77 mmol/mol). Of these, 27 (62.9%) were newly diagnosed, with a mean HbA1c of 9.7% (83 mmol/mol) and a range of 6.6–14% (49–130 mmol/mol). Nearly half (48.1%) of people newly diagnosed with diabetes had an HbA1c over 10.0% (86 mmol/mol). Of those with known diabetes, only 68.8% were receiving any treatment. Mean HbA1c for treated patients was 9.9% (85 mmol/mol). Diabetic retinopathy was identified in 18.6% of people with diabetes, of whom half had no previous diagnosis of diabetes.

Conclusions

This study estimates the prevalence of diabetes at 15% in adults in Timor-Leste, a substantial proportion of whom have evidence of diabetic retinopathy. This is consistent with regional estimates. With the majority of patients undiagnosed, and management of people known to have diabetes largely inadequate, point-of-care testing is a valuable tool to assist with diabetes case detection and management. Whilst only a preliminary estimate, our data provides important impetus for further investigation of the prevalence and impact of diabetes in Timor-Leste. It provides guidance that further investment is required in expanding testing, as well as in prevention and treatment.

【 授权许可】

   
2015 Dawkins et al.

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