scholarly journals Correlation of types of diabetic retinopathy and its psychosocial impact

Author(s):  
Chinmay T. Jani ◽  
Tejas R. Desai ◽  
Sonal Parikh ◽  
Ashka S. Shah

Background: Diabetic retinopathy affects majority (70% to 90%) of diabetic patients, causes visual impairment which leads to severe psycho-social disruption in life. Our objective was to study the patients of diabetic retinopathy, co-relate between the types of diabetic retinopathy and the extent of psychosocial impairment in these patients.Methods: Data of the diabetic patients attending the Retina Clinic of C.H. Nagri Eye Hospital, Ahmedabad was collected using a pretested questionnaire. It included ocular history, history related to diabetes, data of ocular examination and type of retinopathy (if present). For psycho-social assessment, the patients were asked to fill the validated Gujarati language version of “General Health Questionnaire -28 (GHQ 28).” Selfscoring was done ranging from 0-1-2-3 (lower to higher disability respectively). Analysis of significance was carried out by Mann-Whitney Test using statistical software.Results: Total 308 patients were studied. The subjects were divided into 3 groups: (A) Diabetes mellitus type-2 (DM-2) patients without retinopathy. (B) DM-2 patients having non-proliferative retinopathy (C) DM-2 patients having proliferative retinopathy. According to the accepted scoring pattern of GHQ-28 (cut of point 25), it was observed that 80.26% of patients having non-proliferative retinopathy in both eyes and 93.75% patients having proliferative retinopathy in both eyes were psychosocially impaired. The impairment was found to be more severe in proliferative retinopathy patients as compared to non-proliferative retinopathy patients. (p value <0.005) (mean GHQ score in PDR=41.88 >NPDR = 35.74). It was also found that in DM-2 patients without retinopathy the average mean score was 25.22 which showed less impairment (p value <0.005).Conclusions: Patients of Diabetic Retinopathy had more psychosocial impairment which shows its significant impact on quality of life and overall health. Psychiatric counselling must be given to the impaired patients to decrease the impact of the disease on the psychosocial aspect of health. It is necessary to decrease the psychosocial suffering along with the control of disease.

2015 ◽  
Author(s):  
Chinmay T Jani ◽  
Tejas Desai ◽  
Sonal Parikh ◽  
Aashka A Shah ◽  
Sonali Katara

INTRODUCTION: Diabetic retinopathy affects majority (70% to 90%) of diabetic patients, causes visual impairment which leads to severe psycho-social disruption in life. Our objective was to study the patients of diabetic retinopathy, co-relate between the types of diabetic retinopathy and the extent of psychosocial impairment in these patients. MATERIALS AND METHODS: Data of the diabetic patients attending the Retina Clinic of C.H. Nagri Eye Hospital, Ahmedabad was collected using a pretested questionnaire. It included ocular history, history related to diabetes, data of ocular examination and type of retinopathy (if present). For psycho-social assessment, the patients were made to fill the validated Gujarati language version of “General Health Questionnaire -28 (GHQ 28).” Self-scoring was done ranging from 0-1-2-3 (lower to higher disability respectively). Analysis of significance was carried out by Mann-Whitney Test using statistical software. RESULTS: Total 308 patients were studied. The subjects were divided into 3 groups: (A) Diabetes Mellitus Type-2 (DM-2) patients without retinopathy. (B) DM-2 patients having Non-Proliferative Retinopathy (C) DM-2 patients having Proliferative Retinopathy. According to the accepted scoring pattern of GHQ-28 (cut of point 25), it was observed that 80.26% of patients having non proliferative retinopathy in both eyes and 93.75% patients having proliferative retinopathy in both eyes were psychosocially impaired. The impairment was found to be more severe in proliferative retinopathy patients as compared to non-proliferative retinopathy patients. (p value <0.005) (Mean GHQ score in PDR=41.88 > NPDR = 35.74). It was also found that in DM-2 patients without retinopathy the average mean score was 25.22 which showed less impairment (p value <0.005). Detailed analysis showed that there was more impairment in the field of social dysfunction. CONCLUSION: Patients of Diabetic Retinopathy had more psychosocial impairment which shows its significant impact on quality of life and overall health. Psychiatric counselling must be given to the impaired patients to decrease the impact of the disease on the psychosocial aspect of health. It is necessary to decrease the psychosocial suffering along with the control of disease.


2015 ◽  
Author(s):  
Chinmay T Jani ◽  
Tejas Desai ◽  
Sonal Parikh ◽  
Aashka A Shah ◽  
Sonali Katara

INTRODUCTION: Diabetic retinopathy affects majority (70% to 90%) of diabetic patients, causes visual impairment which leads to severe psycho-social disruption in life. Our objective was to study the patients of diabetic retinopathy, co-relate between the types of diabetic retinopathy and the extent of psychosocial impairment in these patients. MATERIALS AND METHODS: Data of the diabetic patients attending the Retina Clinic of C.H. Nagri Eye Hospital, Ahmedabad was collected using a pretested questionnaire. It included ocular history, history related to diabetes, data of ocular examination and type of retinopathy (if present). For psycho-social assessment, the patients were made to fill the validated Gujarati language version of “General Health Questionnaire -28 (GHQ 28).” Self-scoring was done ranging from 0-1-2-3 (lower to higher disability respectively). Analysis of significance was carried out by Mann-Whitney Test using statistical software. RESULTS: Total 308 patients were studied. The subjects were divided into 3 groups: (A) Diabetes Mellitus Type-2 (DM-2) patients without retinopathy. (B) DM-2 patients having Non-Proliferative Retinopathy (C) DM-2 patients having Proliferative Retinopathy. According to the accepted scoring pattern of GHQ-28 (cut of point 25), it was observed that 80.26% of patients having non proliferative retinopathy in both eyes and 93.75% patients having proliferative retinopathy in both eyes were psychosocially impaired. The impairment was found to be more severe in proliferative retinopathy patients as compared to non-proliferative retinopathy patients. (p value <0.005) (Mean GHQ score in PDR=41.88 > NPDR = 35.74). It was also found that in DM-2 patients without retinopathy the average mean score was 25.22 which showed less impairment (p value <0.005). Detailed analysis showed that there was more impairment in the field of social dysfunction. CONCLUSION: Patients of Diabetic Retinopathy had more psychosocial impairment which shows its significant impact on quality of life and overall health. Psychiatric counselling must be given to the impaired patients to decrease the impact of the disease on the psychosocial aspect of health. It is necessary to decrease the psychosocial suffering along with the control of disease.


2020 ◽  
Vol 17 (34) ◽  
pp. 867-873
Author(s):  
Dhfer ALSHAYBAN ◽  
Royes JOSEPH

Diabetes is a common chronic disease that is considered as one of the fastest-growing health problems in the world. Adherence to medications could be an important factor in reducing these complications and improving the quality of life. The purpose of this research was to assess the impact of treatment adherence on health-related quality of life in patients with type 2 diabetes. A multicenter cross-sectional study was carried out among 368 diabetes patients. General Medication Adherence Scale was used to assess the adherence level and EuroQol-5D to assess the quality of life. The results show that 19%, 21%, and 23% of patients had maintained low medication adherence due to patient’s intentional or unintentional behavior due to additional diseases or pills burden and due to financial constraints, respectively. Overall, 43% (n=162) participants had maintained high medication adherence, and 37% (n=138) had maintained low medication adherence to antidiabetic drugs. Nearly one-third (31%) of patients with high overall adherence had perfect health state in comparison with 4% among patients with low adherence. Further, the lower proportion (21%) of patients with high overall adherence had perfect health state in comparison with that among patients with low adherence (34%). In addition to the overall adherence, the association was statistically significant for the domains related to non-adherence due to the patient’s intentional or unintentional behavior (p-value 0.001) and non-adherence due to additional diseases or pills burden (p-value 0.001) after taking into account of socio-demographic and clinical characteristics. In conclusion, the findings suggest that the policymakers should establish an intervention to improve adherence to diabetic treatment, and thus improve the quality of life for the type 2 diabetic patients.


2020 ◽  
Vol 68 (5) ◽  
pp. 848
Author(s):  
Subina Narang ◽  
Jyoti Deswal ◽  
Nitin Gupta ◽  
Jitender Jinagal ◽  
Meenakshi Sindhu

2019 ◽  
Vol 15 (4) ◽  
pp. 288-293
Author(s):  
Osama B. Albasheer

Background: The purpose of this study is to determine the impact of depressive symptoms on the quality of life of type 2 diabetic patients (T2DM). Methods: A cross-sectional study of 332 T2DM patients aged ≥18 years living in Jazan region of Saudi Arabia was conducted. Validated questionnaire was used for demographic and disease characteristics. Depressive symptoms of the participants were assessed using the Patient Health Questionnaire (PHQ-9). The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) was utilized to assess the degree of life enjoyment and satisfaction. Results: Depressive symptoms were observed in 34.7% (112) of the total participants. The overall sense of wellbeing (mean 3.23, P. value 0.000), physical (mean 3.37, P. value 0.003), psychosocial (mean 2.99 P. value 0.000) and social domains (mean 3.53, P. value 0.000) of quality of life were significantly reduced in T2DM patients with depressive symptoms. Conclusion: The impact of depressive symptoms on quality of life of T2DM patients was more significant than the impact of diabetes alone. Symptoms of depression reduce the individual coping and hence reduce functioning. This study emphasizes the vital importance of an integrated holistic approach that addresses both the practical and emotional issues in diabetes care.


2018 ◽  
Vol 103 (9) ◽  
pp. 1314-1319 ◽  
Author(s):  
Eva K Fenwick ◽  
Ryan E K Man ◽  
Alfred Tau Liang Gan ◽  
Neelam Kumari ◽  
Charlene Wong ◽  
...  

Background/aimsTo assess the independent impact of diabetic retinopathy (DR) on three domains of vision-related quality of life (VRQoL) in a Chinese Singapore population.MethodsThe Singapore Chinese Eye Study (n=3353; 2009–2011) was a population-based, prospective, cross-sectional study conducted at the Singapore Eye Research Institute. The study population included 292 adults with diabetes, with and without DR. DR (better eye) was categorised as presence and absence of any DR; severity of DR (no vision-threatening DR (VTDR); severe non-proliferative DR (NPDR); PDR and/or clinically significant macular oedema and VTDR). Our main outcome was VRQoL which was measured using Rasch-calibrated scores from the ‘Reading’, ‘Mobility’ and ‘Emotional’ domains of the Impact of Vision Impairment questionnaire. The relationship between DR and VRQoL was assessed using multiple linear regression models.ResultsOf the 292 individuals (mean age 61.35 ± 9.66 years; 55.8% male), 201 (68.8%), 49 (16.8%), 20 (6.8%), 22 (7.5%) and 27 (9.2%) had no DR, minimal-mild NPDR, moderate-severe NPDR, PDR and VTDR, respectively. Any DR and VTDR were independently associated with 6% and 12% worse Reading scores and 7% and 18% poorer Emotional well-being, respectively, compared with those without DR. These associations persisted after separate adjustment for visual impairment and presenting visual acuity. No significant difference was found in the Mobility domain between persons with and without DR.ConclusionsWe documented that DR, particularly VTDR, was independently associated with restrictions in Reading and Emotional well-being. Understanding factors underlying the detrimental DR-VRQoL relationship may optimise rehabilitation outcomes for individuals with DR.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Miao Liu ◽  
Jianhua Wang ◽  
Yao He

Aims. This study aimed at assessing the impact of baseline bilirubin (TBiL) on the incidence of diabetic retinopathy (DR) based on a five-year cohort study which consisted of 5323 Chinese male diabetic patients.Methods. A cohort study based on 5323 male diabetic patients was conducted in Beijing, from 2009 to 2013. Both baseline TBiL and follow-up changes were measured. Cox proportional risk model was used to calculate the hazard ratio (HR) of TBiL for DR risk.Results. During the follow-up period, there were 269 new DR cases. The incidence of five-year follow-up was 5.1% (95% CI: 4.5%~5.6%). The TBiL level of those who had diabetic retinopathy was lower than that of those without (12.51+ 1.20 mol/L and 13.11+ 1.32μmol/L,P=0.033). And more interestingly, along with the quintiles of baseline TBiL, there showed a U-shaped curve with DR incidence. And the RRs were 0.928 (95% CI: 0.646–1.331), 0.544 (95% CI: 0.365–0.811), 0.913 (95% CI: 0.629–1.324), and 1.035 (95% CI: 0.725–1.479) for the second, third, fourth, and fifth quintiles of baseline TBiL levels, respectively, compared with the first quintile. For follow-up TBiL changes, after being adjusted for related covariables and baseline TBiL levels (as continuous variable) in the model, the RRs for DR were 1.411 (95% CI: 1.081–1.842) for those who had decreased TBiL level and 0.858 (95% CI: 0.770–0.947) for those who had increased TBiL level during follow-up. And this association was more prominent among those with lower baseline TBiL level.Conclusions. Serum TBiL had a U-shaped relationship with DR incidence, which was independent of control status of diabetes and other related covariates.


2018 ◽  
Vol 14 (1) ◽  
pp. 264-269 ◽  
Author(s):  
Patricia Ciminelli ◽  
Sergio Machado ◽  
Manoela Palmeira ◽  
Mauro Giovanni Carta ◽  
Sarah Cristina Beirith ◽  
...  

Background: Emotional stress is frequently associated with otologic symptoms as tinnitus and dizziness. Stress can contribute to the beginning or worsening of tinnitus. Objective: The objective of the study is to evaluate the presence of stress symptoms in patients with chronic, subjective tinnitus, and correlate its presence to annoyance associated with tinnitus. Methods: This is a cross-sectional study. One hundred and eighty patients with chronic, subjective tinnitus were included. Patients answered the Tinnitus Handicap Inventory (THI) to evaluate the impact of tinnitus in the quality of life and answered the Lipp's inventory symptoms of stress for adults (ISSL). The data obtained was organized using Excel® 2010, mean values, linear regression and p-value were calculated. Results: Of the 180 patients included in the study, 117 (65%) had stress symptoms, 52 of the 117 (44%) were in the resistance phase and 23 of the 117 (20%) in the exhaustion phase, the remaining was in the alert phase. There was a clear progressive increase in stress as THI raised, with more impact of tinnitus in quality of life. Conclusion: The presence of stress symptoms, measured by ISSL was observed in most of our patients with chronic subjective tinnitus, specially in the resistance and exhaustion phases and it is directly associated with tinnitus annoyance.


Author(s):  
Devashish Palkar ◽  
Sanjibani Panigrahi ◽  
Pooja Shatadal ◽  
Ritambhara Mehta

Introduction: Academic examinations are a very stressful event for an Bachelor of Medicine and Bachelor of Surgery (MBBS) student. While many students learn to deal with it through the use of helpful or unhelpful coping skills, many still end up with considerable psychological morbidity in the form of anxiety and depression along with deterioration in overall health. Jacobson’s Progressive Muscle Relaxation (JPMR) causes deep muscle relaxation. Aim: To find out the prevalence of stress and exam anxiety in students of 1st year MBBS and to study the impact of JPMR. Materials and Methods: It was a quasi-experimental, pretest and post-test interventional study conducted amongst the first year MBBS students studying at the Government Medical College Surat, Gujarat, India, during March to May 2019. Two months before their internal exams, 114 1st year MBBS students were recruited for the study. They were given a pretest proforma which comprised of socio-demographic profile, Perceived Stress Scale (PSS), Test Anxiety Scale (TAS) and General Health Questionnaire (GHQ) 28. They were asked to attend JPMR sessions over the following month in batches of 30 each and asked to practise JPMR for one month leading up to their exams. Total 43 students attended these sessions while 71 did not. After one month, all 114 students were again given a post-test proforma comprising of the same scales. Paired t-test was applied to compare the pretest and post-test scores to see the impact of JPMR. Results: The mean age of participants was 19 years.The students who completed their schooling in Gujarati medium and those who reported to be staying at hostel experienced significantly more TAS scores at baseline evaluation as compared to their counterparts from English medium schools and those staying at home respectively. There was a statistically significant reduction in mean scores of PSS and TAS before and after practice of JPMR in the 43 students who attended and practiced JPMR (p-value=0.005 and p-value=0.002, respectively; p-value <0.05 was considered to be significant). Conclusion: One month practice of JPMR was found to be effective in reduction of stress and exam anxiety.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A414-A414
Author(s):  
Ibrahim Naoum ◽  
Abedalghani Abedalhalim ◽  
Amir Aker ◽  
Luai Khalaili ◽  
Sameer Kassem

Abstract Background: Diabetes and chronic obstructive pulmonary disease (COPD) are widely prevalent and comorbidity with these diseases is quite common. However, there is limited data on the interrelation between glycemic control and COPD exacerbations in diabetic patients. Objective: To study the association between pre-admission glycemic control and COPD clinical outcomes including mortality, risk of hospital readmission and the need for mechanical ventilation. Methods: A retrospective population-based cohort study. We screened for patients with both diabetes and COPD exacerbation aged 35 years and above. Pre-admission glycemic control was defined by the last HBA1C level prior to hospitalization. Patients with HBA1C&gt;8% were defined as uncontrolled. We evaluated the difference between controlled and uncontrolled groups in the rates of mortality, readmission and the need for mechanical ventilation. We examined demographic and clinical parameters that might reflect COPD severity including: COPD medication use, blood hemoglobin, platelets, LDH and CRP levels. Results: 513 hospitalizations with diabetes and COPD were screened. 222 hospitalization were excluded either due to unestablished diagnosis of COPD or due to lack of HBA1C test in the preceding year. Of the remaining 291, 208 admissions were with controlled diabetes whereas 83 were uncontrolled. Although not statistically significant, the rate of re-hospitalization was higher in the uncontrolled group (OR 1.99, CI 0.99–4.0, p-value 0.051). There was no statistically significant difference in mortality (OR 1.6, CI 0.73–3.5, p-value 0.243). The use of oxygen and the need for noninvasive mechanical ventilation were significantly higher in the uncontrolled group (67.5% vs. 52.4%, p-value 0.019, 33.7% versus 18.8%, p-value 0.006, respectively). There was no significant difference in possible confounders tested between the groups. Conclusion: Uncontrolled diabetes may adversely affect patients with COPD exacerbation. Larger studies are needed to conclusively determine the impact of glycemic control on COPD morbidity and mortality.


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