Dawkins, RCH and Oliver, GF and Sharma, M and Pinto, BM and Jeronimo, B and Pereira, B and Magno, J and Motta, LA and Verma, N and Shepard, M, An estimation of the prevalence of diabetes mellitus and diabetic retinopathy in adults in Timor-Leste, BMC Research Notes, 8 Article 249. ISSN 1756-0500 (2015) [Refereed Article]
© 2015 Dawkins et al. Licensed under Creative Commons Attribution 4.0 International (CC BY 4) http://creativecommons.org/licenses/by/4.0/
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.
|Item Type:||Refereed Article|
|Keywords:||Timor-Leste, East Timor, diabetes mellitus, diabetic retinopathy, point-of-care testing, HbA1c, cataract|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Author:||Verma, N (Dr Nitin Verma)|
|Deposited By:||Medicine (Discipline)|
|Downloads:||133 View Download Statistics|
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