Associations Between Demographic Characteristics, and Diabetes‐Related Knowledge, Attitudes, Practices and Clinical Parameters in People With Diabetes Attending Eye Clinics in Trinidad and Tobago: A Cross‐Sectional Study
Raju Sapkota, Ngozika E. Ezinne, Hugo Onumajuru, Shahina PardhanABSTRACT
Background and Aims
Diabetes‐related knowledge, attitudes, and practices (KAP) and associated clinical outcomes, including diabetic retinopathy (DR), have not been adequately examined across patient demographics in Trinidad and Tobago (T&T), which this study examined.
Methods
A total of 194 patients with diabetes (age = 59.56 ± 12.9 years, diabetes duration = 14.29 ± 11.2 years; 59.3% females) attending various eye clinics were recruited via convenience sampling. KAP was assessed using a validated questionnaire. Data on duration of diabetes/treatment, height/weight, blood pressure, fasting blood glucose (FBG) level, and DR status and severity were obtained from recent medical records. Associations between independent (age, gender, education level, employment status) and dependent variables (KAP, clinical data) were explored.
Results
Of the total participants, 43.8% (85/194) were employed, 82.0% (159/194) had above primary‐level education, 51.0% (99/194) were 60 years or older, 49.5% (96/194) reported doing regular physical activity, 60.6% (117/194) would be less concerned at forgetting diabetes medication, and 36.1% (70/194) were unaware that diabetic eye exam differed from basic eye test for spectacles. Females were less willing to discuss their diabetes openly, along with younger participants. DR status/severity was recorded for 78.3% (152/194) using Early Treatment Diabetic Retinopathy Study classification; 42.8% had DR, and 5.7% had sight‐threatening DR (moderate non‐proliferative DR or worse, and/or the presence of diabetic macular edema). FBG (OR = 1.04, 95% CI: 1.01–1.07, p = 0.006) and lower (below secondary) level of education (OR = 8.3, 95% CI = 1.53–44.7, p = 0.014) predicted DR presence independently.
Conclusion
Notable gaps in diabetes‐related KAP were observed. Women/younger participants were less willing to discuss their diabetes openly. More women knew the importance of physical activity than men. Elevated FBG and lower education levels were independently associated with DR. Our findings support the need for demographically targeted education interventions for diabetic patients attending eye clinics in T&T.