Many Hispanics with diabetes unaware of potential eye disease, do not receive eye exams

Hispanic patients with diabetes appear to have less frequent eye examinations than the national average for Hispanic individuals, and many are not aware of the potential ocular complications of diabetes, according to a report in the July issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

One in five Hispanic individuals older than 40 years currently has diabetes, and almost half have diabetic retinopathy, a related eye disease, according to background information in the article. “The limited use of health care services in minority groups may make them more susceptible to the complications of uncontrolled diabetes,” the authors write. “In addition, a substantial proportion of those with diabetes are unaware of their condition, although already presenting signs of moderate to severe diabetic retinopathy. The importance of appropriate and timely care for diabetic retinopathy or macular edema [swelling in the retina] is paramount, as it is the leading cause of visual loss among working-age Hispanic individuals.”

Beatriz Muñoz, M.Sc., of the Wilmer Eye Institute, Johns Hopkins University, Baltimore, and colleagues interviewed 349 randomly selected Hispanic individuals without diabetes and a group of 204 Hispanic individuals with diabetes. Participants answered questions about demographic information, health care habits and knowledge of diabetes and diabetic retinopathy.

The researchers found that:

* Less than 10 percent of participants preferred reading in English

* 50 percent reported language barriers to health care

* Knowledge of eye disease as a consequence of diabetes was reported by 18 percent of non-diabetics with no family history of diabetes, 29 percent of non-diabetics with a family history of diabetes, 36 percent of those newly diagnosed with diabetes and 52 percent diagnosed with diabetes more than a year prior

* 16 percent of non-diabetics with no family history, 28 percent of non-diabetes with a family history, 13 percent of those newly diagnosed with diabetes and 34 percent diagnosed more than a year prior know that strict control of diabetes could prevent eye problems; 33 percent, 51 percent, 31 percent and 48 percent, respectively, knew dilated eye examinations were important

* Less than one-third (30 percent) of diabetic participants had had an eye examination in the previous year, compared with 70 to 75 percent in national samples of Hispanics

* Almost half of those with diabetes for more than one year and 79 percent of those diagnosed in the previous year had never had a dilated eye exam

“The lack of correct information about diabetes and diabetic eye disease in this population of Hispanic individuals should be of great concern,” the authors conclude. “The frequency of dilated eye examinations among people with diabetes was unacceptable, and places this population at risk of visual loss. These deficiencies need to be rectified with a culturally appropriate health education campaign, and with innovative ways to reduce barriers to health care.”

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(Arch Ophthalmol. 2008;126[7]:968-974. Available pre-embargo to the media at www.jamamedia.org.)

Editor’s Note: This project was supported by a grant from the National Eye Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.”*

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