To Study The Prevalence of Eye Complications Among Diabetic Patient

Al-neelain University
Research proposal in:
To study the prevalence of eye complications among diabetic patient

Done by: Maal Abd Al-hafeez Ibrahim Supervisor: D. Muna hassan
Introduction:
Diabetes mellitus describe a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbance of carbohydrate, fats and proteins metabolism(3). Diabetes is a chronic disease, which occur when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin produced. this lead to an increase concentration of glucose in the blood. There types are: Type 1: characterized by lack of insulin production (insulin dependent diabetes). Type 2: caused by the body ineffective use of insulin, or excess body weight and physical inactivity (non-insulin dependent diabetes). Gestational diabetes is a hyperglycemia that is recognized during first pregnancy.
Diabetes nowadays can be considered as the most common chronic non-curable community disease. The effects of diabetes include long term damage, dysfunction and failure of various organs. Also it causes many systemic diseases (cardiovascular, cerebrovascular accident, renal insufficiency, blindness, sexual importance and gangrene of the feet leading to amputation) that can be considered as a complication of long term un-controlled diabetes, Consistent control of blood glucose reduces the development and procession of diabetic eye problems considerably. Diabetes eye problems occur when blood glucose levels are left untreated, or may be hereditary and exacerbated by diabetes (such as cataracts and glaucoma).
Diabetic retinopathy is the most common form of eye problem affecting people with diabetes, but further diabetes-related eye problems are common - such as glaucoma and cataracts. Diabetic retinopathy is a leading cause of blindness and visual disability. Diabetic retinopathy occurs when changes in blood glucose levels cause changes in retinal blood vessels It cause a small blood vessels damage leading to progressive loss of vision, when usually the patients complain of blurred vision, its progresses through three clear stages: background neuropathy, maculopathy and proliferative retinopathy Cataracts are cloudy opacification of the lens of the eye. This interferes with vision; The lens of the eye is made up of fluids, when the fluid start to cloud over it cause the opacification people with diabetes mellitus statistically face a 60% greater risk of developing cataracts. Glaucoma is caused by excess fluid pressing on the nerve at the back of the eye. Diabetic retinopathies increase the risk of glaucoma. My aim is to study the complication that can be caused by diabetes in the eye and their prevalence and the percentage of blindness that can occur.
Problem in the world:

347 million people worldwide have diabetes; more than 80% of the people with diabetes live in low and middle income countries. Diabetes deaths will double between2005 and2030 Diabetes mellitus is a major cause of blindness in the United States and is the leading cause of new blindness in working-aged Americans. Prevalence of diabetes mellitus (I & II) = 3% -5% ( = 30,000 50,000 diabetics/million population). Prevalence of any retinopathy in diabetics = 20% ( = 6,000 10,000 with diabetic retinopathy/million population). Prevalence of blindness among these is 5% ( = 300 - 500 blind/million population i.e., 5% all blindness). Diabetic retinopathy alone accounts for at least 12% of new cases of blindness each year in the United StatesThe estimated annual incidence of new cases of proliferative diabetic retinopathy and diabetic macular edema are 65,000 and 75,000, respectively. Approximately 700,000 Americans have proliferative diabetic retinopathy --the most sight- threatening form of retinopathy -- and 500,000 have diabetic macular edema. The longer a person has diabetes, the greater the risk becomes of developing diabetic retinopathy. Furthermore, cataracts occur at a younger age and progress more rapidly in people with diabetes. Also glaucoma with their types is common. the prevalence of glaucoma increases with the patient's age and with the length of time the patient has had diabetes. Neovascular glaucoma is a more severe type of glaucoma that most commonly occurs among patients with severe proliferative diabetic retinopathy and retinal detachments.
Justification:
People with diabetes are 25 times more at risk for blindness than the general population. 70% of people with insulin- dependent diabetes mellitus (IDDM) will develop proliferative diabetic retinopathy, and 40% will develop macular edema. Both complications, if untreated, frequently lead to serious visual loss and disability. Fortunately laser surgery can reduce the risk of visual loss from proliferative diabetic retinopathy by approximately 60%. And laser surgery also can reduce the risk of visual loss from clinically significant diabetic macular edema by 50%. Vitrectomy can restore useful vision in some diabetic patients whose retinopathy is too advanced for laser surgery.
Cataracts are 1.6 times more common in people with diabetes than in those without diabetes. Patient with IDDM occasionally develop snowflake or metabolic cataracts. Nowadays, cataract extraction with or without lens implantation is 90% to 95% successful in restoring useful vision.
Open-angle glaucoma is 1.4 times more common in the diabetic population. While the Medical therapy for open-angle glaucoma is effective.
Objectives:
General:
To study the prevalence, knowledge and practices regarding eye complications among diabetic patient.
Specific:
Estimate proportion of diabetic patients with loss of vision
To measure the eye complication related to diabetic patients.
Research methodology:
Study design:
Descriptive cross-sectional study design.
Study area:
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Study population:
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Sample size: Could be calculated from the formula N =Z^2PQ/D^2 When N: sample size. Z: normal standard deviation P: frequency of occurrence of an event Q: 1-P D: degree of precision N = (1.96)^2 *0.2 *0.8/(0.04)^2 =384 But I cannot obtain this sample size due to financial consideration, and I will take 100 sample as a sample size.
data collection technique:

As a form of interview using questionnaire
The Variables that my study depend upon: Dependent: eye complication due diabetes. Independent: Background information (age, gender), Diabetes, period of diabetes, diabetic control, drug that use to control diabetes. Loss of vision
Ethical consideration:
I will Take a Permission from the faculty, from the hospital and also consent from patient them selfs.
Data analysis plan:

I will analyze the data manually, and use the prevalence equation and odds ratio to calculate the prevalence.
Work plan:
Activities Proposal writing Questionnaire writing Print questionnaire Data collection Data analysis Research writing
1- 3- 5- 7- 8- 911- 13- 152w 4w 6w 8w 9w 10w 12w 14w 16w
Budget: print out Transport

Total coast
150p 60p
210 p
Reference:
Cdc.gov Who.org Diabetic.co.uk

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Al-neelain University

Research proposal in:

To study the prevalence of eye complications among diabetic patient

Problem in the world:

data collection technique:

Data analysis plan:

1- 3- 5- 7- 8- 911- 13- 152w 4w 6w 8w 9w 10w 12w 14w 16w

Budget: print out Transport

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