More diabetes patients losing sight, reveals medical survey

George Kebaso @Morarak

If you are diabetic and for years you have not visited an eye specialist for sight test, you risk becoming blind, eye experts have warned in a new survey.

One-month study by Operation Eyesight Universal in partnership with the Ministry of Health at Kitale Level Five Referral Hospital linked late diagnosis of diabetic retinopathy (DR) to blindness.

About 1.5 million Kenyans are diabetic and between 24 and 30 per cent of them (up to 500,000), are struggling with various eye problems.

Worse still, experts warn candidates for blindness do not exhibit noticeable symptoms. “A diabetic patient could be normal today, reading his newspapers even up to late night, but wake up the following day blind,” said Dr Kibata Githeko, a consultant ophthalmologist.

He said three of every 10 people with diabetes are likely to become blind at the end of the year, attributing this to late diagnosis of the DR “Diabetes, especially the one affecting the retina of the eye, is an emerging major cause of blindness in the world,” he added.

It is estimated that two per cent of adult Kenyans have diabetes type two.

The DR study, conducted to assess the magnitude, risk factors and capacity to manage DR, found out that female diabetes patients were more susceptible to blindness caused by the disease than male counterparts.

Out of the 256 patients who attended the diabetes clinic, 253 were screened where 98 were male, while 155 were women, the study said.

In the study, most patients (58.9 per cent) were not educated beyond primary school level and, again, women presented a significant number compared to men.

The principal investigator in the study, Prof Jefitha Karimurio said this could mean awareness on diabetes and other general health conditions could be low among lowly-educated people.

The study found out that 16.3 per cent of diabetics attending clinic at the Kitale hospital have DR. “These findings are consistent with what other hospital-based studies show in the region. A recent review found the prevalence of DR among diabetics in Eastern Africa to range between 10 and 47 per cent,” said Karimurio.

Almost all patients in this study, he said, were married, an indication they were likely to have strong social support, which is important especially with the patients with visual impairment.

However, he added that about a half of the patients were unemployed and more than a half did not have active hospital insurance covers.

“The findings imply that most patients were of low social economic status and they were paying out-of-pocket for healthcare services. Health is one of the key pillars of the ‘Big Four’ government agenda for the period 2018 to 2022. Increase of National Hospital Insurance Fund (NHIF) coverage is one the strategies being used to meet the goal of Universal Health Coverage,” he added.

As a result, Kitale Hospital should actively sensitise diabetic patients on the need to acquire the insurance cover to provide financial protection and reduce out-of-pocket payments.

An estimated 86.4 per cent of the patients in the study had normal vision but the prevalence of blindness from all likely causes was higher than in the general population.

The Ministry of Health estimates that the prevalence of blindness in Kenya is 0.7 per cent compared to 3.2 per cent in this study.

The study shows that of the 256 diabetes patients screens for DR, 28 had lived with diabetes for one year.

A study across a number of communities in Kenya in 2009 showed that the overall age-standardised prevalence for diabetes mellitus was 4.2 per cent. The Stepwise study conducted in 2015 by the Ministry of Health revealed that 3.1 per cent and 1.9 per cent of adults aged 18-69 years had impaired fasting glycaemia and raised blood glucose, respectively.

The most common type of diabetes is type 2, usually found in adults. After about 20 years, diabetes mellitus type 2 seems to cause DR which in turn leads to loss of sight, retinal scars and macular oedema.

At the same time, in a new study, eye experts say a person can save more than Sh100,000 in treatment costs if they can go for early screening.

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