Abstract:
ntroduction: Diabetic retinopathy is one of the most common
microvascular complications seen in diabetic patients after a
long term of uncontrolled glycaemic status as assessed by
glycosylated Haemoglobin A (HbA1c). Hence awareness of
glycaemic control is necessary to prevent vision threatening
complications.
Aim: To assess the awareness regarding association between
glycosylated Haemoglobin (HbA1c) and diabetic retinopathy
among diabetic patients and to assess the impact of lack of this
knowledge on the severity of diabetic retinopathy (DR).
Materials and Methods: This hospital based cross-sectional
study was conducted in the ophthalmology OPD on 200 adult
diabetic patients, between November 2012 and January 2013,
who were assessed for their knowledge regarding association
between HbA1c and its impact on the progress of DR. The study
was done with the help of a semi structured questionnaire which
included demographic details, literacy levels, diabetic status and
awareness of HbA1c.
Statistics Used: Cochran Armitage test for trend, Fisher Exact
test, chi-square for trend and Student’s t test.
Results: Among the 200 diabetic individuals attending our OPD,
180 (90%) were aware of the importance of blood sugar levels and
its fluctuation in type 2 diabetes. Only 23 (11.5%) were aware of
HbA1c whereas 10 (5%) misinterpreted it as levels of haemoglobin,
3 (1.5%) did not completely comprehend. About 164 (82%)
patients were not aware of the significance or the terminology of
HbA1c. Out of the 200 patients, 58 patients showed presence of
some grade of DR. Amongst these 58 patients, 7(12.1%) were
aware of HbA1c and all the11 patients with clinically significant
macular oedema (CSME) were aware of the risk factors of elevated
blood sugar levels but ignorant of HbA1c. Among the remaining
142 individuals who showed no signs of DR, 16 (27.5%) were
aware of and comprehended the role of HbA1c.
Conclusion: Our study highlights the gross ignorance of role
of HbA1c in the progress of DR among diabetic individuals. It is
a known fact that the risk of DR reduces by 35% for every 1%
reduction in HbA1c. Hence a strict control of blood sugar level
with regular monitoring of HbA1c can help diabetic individuals in
prevention of progress of DR, thus preventing severe vision loss.
