Diabetic Hispanics Not Receiving Proper Eye Care

Editor's Choice
Main Category: Eye Health / Blindness
Also Included In: Diabetes
Article Date: 18 Jul 2008 - 0:00 PST

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A new study published in the July issue of Archives of Ophthalmology finds that eye exam frequency among Hispanic patients with diabetes is smaller than the national average for Hispanics. Beatriz Munoz, M.Sc. (Wilmer Eye Institute, Johns Hopkins University, Baltimore) and colleagues also report that diabetic Hispanics are unaware that diabetes is associated with eye disorders.

"The limited use of health care services in minority groups may make them more susceptible to the complications of uncontrolled diabetes," write the authors. "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." About 20% of Hispanic individuals over 40 years old suffer from diabetes and about 50% of these have the eye condition called diabetic retinopathy, which can lead to blindness.

This study utilized data from interviews of randomly selected Hispanic individuals without diabetes (349 participants) and with diabetes (204 participants). Muñoz and colleagues also asked questions about demographics, health care habits, and specific medical knowledge about diabetes and diabetic retinopathy.

The researchers found that of the total, less than 10% indicated a preference for reading in English and 50% said that language was a barrier to health care. Participants knew that diabetes could lead to a serious eye disease in the following proportions:

• 18% of non-diabetics with no family history of diabetes
• 29% of non-diabetics with a family history of diabetes
• 36% of those newly diagnosed with diabetes
• 52% of those diagnosed with diabetes more than one year before
  

Participants reported that they were aware of preventing eye problems by strictly controlling diabetes in the following proportions:

• 16% of non-diabetics with no family history of diabetes
• 28% of non-diabetics with a family history of diabetes
• 13% of those newly diagnosed with diabetes
• 34% of those diagnosed with diabetes more than one year before

Participants indicated that they knew of the importance of dilated eye examinations in the following proportions:

• 33% of non-diabetics with no family history of diabetes
• 51% of non-diabetics with a family history of diabetes
• 31% of those newly diagnosed with diabetes
• 48% of those diagnosed with diabetes more than one year before

National samples of Hispanics have shown that about 70 to 75% have had eye examinations in the past year, but only 30% of diabetic Hispanics have. In addition, about half of Hispanics who have had diabetes for over a year, and 79% of those diagnosed one year ago, indicated that they never received a dilated eye exam.

The authors conclude that: "The lack of correct information about diabetes and diabetic eye disease in this population of Hispanic individuals should be of great concern. 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."

Knowledge of Diabetic Eye Disease and Vision Care Guidelines Among Hispanic Individuals in Baltimore With and Without Diabetes
Beatriz Muñoz, MSc; Michael O'Leary, MA; Fannie Fonseca-Becker, PhD; Evelyn Rosario, BS; Isabel Burguess, BS; Marcela Aguilar, MPH; Cynthia Fickes, BA; Sheila K. West, PhD
Archives of Ophthalmology (2008). 126[7]: pp. 968 - 974.
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Written by: Peter M Crosta
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