AUTHOR=Zang Bo , Rong Shisong , Li Dong , Ding Xiaoxia , Zang Dongxiao , Wang Fenghua , Liang Yuanbo , Zhai Gang , Feng Kemi , Zhou Zixi , Wang Yu 

TITLE=Undiagnosed diabetic retinopathy in Northeast China: prevalence and determinants

JOURNAL=Frontiers in Endocrinology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1263508

DOI=10.3389/fendo.2023.1263508

ISSN=1664-2392

ABSTRACT=<sec><title>Objective</title><p>To report the prevalence and contributing factors of undiagnosed diabetic retinopathy (DR) in a population from Northeastern China.</p></sec><sec><title>Subjects/Methods</title><p>A total of 800 subjects from the Fushun Diabetic Retinopathy Cohort Study were enrolled. A questionnaire assessing incentives and barriers to diagnosis of DR was administered. Logistic regression was used to identify clinical and sociodemographic factors associated with undiagnosed DR. In a prespecified subgroup analysis, we divided patients into vision-threatening diabetic retinopathy (VTDR) and non-VTDR (NVTDR) subgroups.</p></sec><sec><title>Results</title><p>Among 800 participants with DR, 712 (89.0%) were undiagnosed. Among 601 with NVTDR, 566 (94.2%) were undiagnosed. Among 199 with VTDR, 146 (73.4%) were undiagnosed. The risk factors affecting the timely diagnosis of NVTDR and VTDR exhibit significant disparities. In multivariate models, factors associated with undiagnosed VTDR were age over 60 years (<italic>OR</italic> = 2.966; 95% <italic>CI</italic> = 1.205-7.299; <italic>P</italic> = 0.018), duration of diabetes over 10 years (<italic>OR</italic> = 0.299; 95% <italic>CI</italic> = 0.118-0753; <italic>P</italic> = 0.010), visual impairment or blindness (<italic>OR</italic> = 0.310; 95% <italic>CI</italic> = 0.117-0.820; <italic>P</italic> = 0.018), receiving a reminder to schedule an eye examination (<italic>OR</italic> = 0.380; 95% <italic>CI</italic> = 0.163-0.883; <italic>P</italic> = 0.025), and the belief that “people with diabetes are unlikely to develop an eye disease” (<italic>OR</italic> = 4.691; 95% <italic>CI</italic> = 1.116-19.724; <italic>P</italic> = 0.035). However, none of the factors were associated with undiagnosed NVTDR (all <italic>P</italic> ≥ 0.145).</p></sec><sec><title>Conclusion</title><p>Our research has uncovered a disconcerting trend of underdiagnosis in cases of DR within our population. Addressing determinants of undiagnosed DR may facilitate early detection.</p></sec>