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"Objective To investigate the cognition and behavior of diabetic retinopathy (DR) in patients with type 2 diabetes aged 50 and above in Funing County, Yancheng City, Jiangsu Province, and to evaluate its influencing factors. Methods A cross-sectional study was used to conduct cluster random sampling. A total of 84 sampling sites (2 of which were pre-test sites) registered in the Chronic Disease Information Center of Funing County Centers for Disease Control and Prevention (CDC), Jiangsu Province, were selected from patients with type 2 diabetes aged 50 and above. They were investigated by questionnaires, biochemical examination and ocular examinations (including daily visual acuity, anterior segment, and fundus examinations) to understand the general condition, disease history, blood glucose control, presence or absence of DR and the cognitive-behavioral rate of DR (including cognition and behavior). Univariate analysis and multivariate logistic regression analysis were used to identify factors affecting cognition and behavior related to DR. Results A total of 2 067 diabetic patients were enrolled, of whom 1 965 completed the survey, and 1 816 with completion of questionnaire data were included in the statistical analysis. Among them, 666(36.67%) patients were diagnosed with DR. A questionnaire survey containing 12 items was conducted on 1 816 patients, with the total number of cases investigated being 21 792, and the total number of correct answers for the 12 questions being 5 893, so the total cognitive-behavioral rate of DR knowledge was 27.04%. The cognitive-behavioral rate of “what are the ways to learn about DR?” was the highest (60.19%), 26.10% of patients were told by their doctors, “diabetes can cause eye disease” was secondly (58.09%), and “have you attended any DR-related seminars?” was the lowest (3.41%). Multivariate logistic analysis showed that income（OR=1.735， 95%CI： 1.013-2.970）and glycated hemoglobin (HbA1c) level (OR=1.324， 95%CI： 1.031-1.700) were independent risk factors for the cognition and behavior of DR (P＜0.05). 〖JP3〗 Conclusion In the existing chronic disease management system, the cognition and behavior of DR prevention and treatment in patients with type 2 diabetes aged 50 and above in Funing County are relatively low. In order to prevent the onset and progression of DR, it is necessary to strengthen health education and screening, especially from the perspectives of income and HbA1c levels."