Diabetic Hispanics Not Receiving Proper Eye Care

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).? Mu?±oz 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 Mu?±oz, 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