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Diabetic retinopathy incidence, predictors and its association with longitudinal fasting blood sugar level changes among diabetes mellitus patients in Ethiopia: joint model.
- Source :
-
Frontiers in endocrinology [Front Endocrinol (Lausanne)] 2024 Jul 08; Vol. 15, pp. 1363757. Date of Electronic Publication: 2024 Jul 08 (Print Publication: 2024). - Publication Year :
- 2024
-
Abstract
- Background: Diabetes mellitus (DM) is a global public health problem characterized by an elevated blood glucose level. Monitoring blood sugar levels is vital for effective diabetes management and preventing complications. However, the association between longitudinal biomarkers and the incidence of diabetic complications is often overlooked. Therefore, this study aimed to assess the incidence of diabetic retinopathy, predictors, and association with longitudinal fasting blood sugar level changes among diabetes mellitus patients in Ethiopia.<br />Methods: A multicenter retrospective follow-up study was carried out in referral hospitals in Amhara region, Ethiopia. A random sample of 462 newly diagnosed DM patients was selected. The proportional hazard assumption was checked for the survival sub-model, and for the longitudinal sub-model, the normality assumption was checked. Then the joint modeling with time-dependent lagged parameterizations was fitted. Model assumptions and comparisons were checked. Finally, the hazard ratio with a 95% confidence interval (CI) with a corresponding P-value<0.05 was used to identify predictors.<br />Results: In this study, Overall, 54 patients developed DR, and the incidence rate was 2.33 per 1000 person-months over the follow-up period, with a 95% CI of [1.78, 3.05]. Rural residence (AHR = 2.21, 95% CI: [1.21, 4.05]), hypertension co-morbidity (AHR = 3.01, 95% CI: [1.85, 6.53]), and longer duration of DM (>5 years) (AHR = 2.28, 95% CI: [1.91, 5.15]) were important predictors for the incidence of DR. In addition, the incidence of DR was substantially correlated with the time-dependent lagged value of FBS change (AHR = 4.20, 95% CI [1.62, 10.85]).<br />Conclusions: In this study, the incidence of diabetic retinopathy was somewhat high when compared to prior similar studies in Ethiopia. A joint model of longitudinal fasting blood sugar level changes was significantly associated with an increased risk of DR. Besides, being rural residence, hypertension co-morbidity, and a longer duration of DM were significant predictors for the incidence of DR. Therefore, public awareness, an integrated care approach, and prioritizing glycemic control are highly recommended.<br />Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.<br /> (Copyright © 2024 Abuhay, Lakew, Wolde, Mengistu, Legesse and Yenit.)
- Subjects :
- Humans
Ethiopia epidemiology
Female
Male
Incidence
Middle Aged
Retrospective Studies
Adult
Follow-Up Studies
Longitudinal Studies
Risk Factors
Diabetes Mellitus epidemiology
Diabetes Mellitus blood
Aged
Diabetes Mellitus, Type 2 epidemiology
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 complications
Blood Glucose analysis
Blood Glucose metabolism
Diabetic Retinopathy epidemiology
Diabetic Retinopathy blood
Diabetic Retinopathy etiology
Fasting blood
Subjects
Details
- Language :
- English
- ISSN :
- 1664-2392
- Volume :
- 15
- Database :
- MEDLINE
- Journal :
- Frontiers in endocrinology
- Publication Type :
- Academic Journal
- Accession number :
- 39040673
- Full Text :
- https://doi.org/10.3389/fendo.2024.1363757