Prevalence of Diabetic Retinopathy and Its Association with Duration of Diabetes and Glycemic Control in a Community-Based Study

Abstract

Background: Diabetic retinopathy (DR) is one of the most significant microvascular consequences of diabetes mellitus (DM) and continues to be a significant preventable cause of visual impairment. This is more likely to happen with long-standing hyperglycemia and long-standing diabetes. Therefore, it is important that the eyes are identified early to avoid progression to a vision threatening disease. Objective: To determine the prevalence of diabetic retinopathy and evaluate its association with duration of diabetes and glycemic control among adults with diabetes mellitus. Methodology: This cross-sectional community-based study was carried out between January 2025 to June 2025 at Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad. In total 77 adults with diabetes mellitus were included. Demographic and clinical details, duration of diabetes, fasting blood glucose and glycated hemoglobin (HbA1c) were obtained. All participants were subjected to a detailed examination of the eyes to detect and grade DR. The duration of diabetes was classified into three groups: <5 years, 5–10 years and >10 years; HbA1c <7% was regarded as adequate glycemic control. Appropriate statistical tests were used to assess associations and multivariable logistic regression was used. A p-value was considered statistically significant if it was <0.05. Results: Diabetic retinopathy was detected in 24 of 77 participants, giving an overall prevalence of 31.2%. Its prevalence increased from 12.0% among participants with diabetes for <5 years to 29.2% among those with diabetes for 5–10 years and 50.0% among those with a duration >10 years (p = 0.011). Retinopathy was present in 40.8% of participants with HbA1c ≥7%, compared with 14.3% among those with HbA1c <7% (p = 0.031). On multivariable analysis, diabetes duration >10 years and HbA1c ≥7% remained independently associated with diabetic retinopathy. Conclusion: Diabetic retinopathy affected nearly one-third of the study population. Longer duration of diabetes and inadequate glycemic control were the major factors associated with retinal involvement. Regular retinal screening and sustained glycemic control should therefore be prioritized, particularly among patients with long-standing diabetes.