Diabetic retinopathy incidence, predictors and its association with longitudinal fasting blood sugar level changes among diabetes mellitus patients in Ethiopia: joint model

Article


Abuhay, Habtamu Wagnew, Lakew, Ayenew Molla, Wolde, Haileab Fekadu, Mengistu, Berhanu, Legesse, Mandefro Tadesse and Yenit, Melaku Kindie. 2024. " Diabetic retinopathy incidence, predictors and its association with longitudinal fasting blood sugar level changes among diabetes mellitus patients in Ethiopia: joint model." Frontiers in Endocrinology. 15. https://doi.org/10.3389/fendo.2024.1363757
Article Title

Diabetic retinopathy incidence, predictors and its association with longitudinal fasting blood sugar level changes among diabetes mellitus patients in Ethiopia: joint model

ERA Journal ID200516
Article CategoryArticle
AuthorsAbuhay, Habtamu Wagnew, Lakew, Ayenew Molla, Wolde, Haileab Fekadu, Mengistu, Berhanu, Legesse, Mandefro Tadesse and Yenit, Melaku Kindie
Journal TitleFrontiers in Endocrinology
Journal Citation15
Article Number1363757
Number of Pages9
Year2024
PublisherFrontiers Research Foundation
Place of PublicationSwitzerland
ISSN1664-2392
Digital Object Identifier (DOI)https://doi.org/10.3389/fendo.2024.1363757
Web Address (URL)https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1363757/full
Abstract

Background: Diabetes mellitus (DM) is a global public health problem characterized by an elevated blood glucose level. Monitoring blood sugar levels is vital for effective diabetes management and preventing complications. However, the association between longitudinal biomarkers and the incidence of diabetic complications is often overlooked. Therefore, this study aimed to assess the incidence of diabetic retinopathy, predictors, and association with longitudinal fasting blood sugar level changes among diabetes mellitus patients in Ethiopia.

Methods: A multicenter retrospective follow-up study was carried out in referral hospitals in Amhara region, Ethiopia. A random sample of 462 newly diagnosed DM patients was selected. The proportional hazard assumption was checked for the survival sub-model, and for the longitudinal sub-model, the normality assumption was checked. Then the joint modeling with time-dependent lagged parameterizations was fitted. Model assumptions and comparisons were checked. Finally, the hazard ratio with a 95% confidence interval (CI) with a corresponding P-value<0.05 was used to identify predictors.

Results: In this study, Overall, 54 patients developed DR, and the incidence rate was 2.33 per 1000 person-months over the follow-up period, with a 95% CI of [1.78, 3.05]. Rural residence (AHR = 2.21, 95% CI: [1.21, 4.05]), hypertension co-morbidity (AHR = 3.01, 95% CI: [1.85, 6.53]), and longer duration of DM (>5 years) (AHR = 2.28, 95% CI: [1.91, 5.15]) were important predictors for the incidence of DR. In addition, the incidence of DR was substantially correlated with the time-dependent lagged value of FBS change (AHR = 4.20, 95% CI [1.62, 10.85]).

Conclusions: In this study, the incidence of diabetic retinopathy was somewhat high when compared to prior similar studies in Ethiopia. A joint model of longitudinal fasting blood sugar level changes was significantly associated with an increased risk of DR. Besides, being rural residence, hypertension co-morbidity, and a longer duration of DM were significant predictors for the incidence of DR. Therefore, public awareness, an integrated care approach, and prioritizing glycemic control are highly recommended.

Keywordsdiabetic mellitus; incidence; fasting blood sugar; diabetic retinopathy; joint modeling; Ethiopia
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020510599. Medical and biological physics not elsewhere classified
Byline AffiliationsUniversity of Gondar, Ethiopia
School of Health and Medical Sciences
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