Articles Tập 67 Số CĐ13-HNKH Bệnh viện 19-8 09/09/2026

FACTORS ASSOCIATED WITH DIABETIC RETINOPATHY AMONG PATIENTS WITH TYPE 2 DIABETES MANAGED AT PRIMARY HEALTH CARE FACILITIES IN NGHE AN PROVINCE, 2023

Du Hai Nam1,2, Tran Tat Thang1,2, Duong Dinh Chinh3,4, Mai Van Anh Khoa5,6, Tran Nhu Khoa7,8
1 Nghe An Eye Hospital
2 Bệnh viện Mắt Nghệ An
3 Nghe An Department of Health
4 Sở Y tế tỉnh Nghệ An
5 Trung tâm Y tế khu vực Hải Châu
6 Hai Chau Regional Health Center
7 Air Force Institute of Aviation Medicine
8 Viện Y học Phòng không Không quân
DOI: 10.52163/yhc.v67iCD13.6502
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Keywords
diabetic retinopathy; type 2 diabetes; risk factors; logistic regression; primary health care; Vietnam.
Abstract

Background: Diabetic retinopathy (DR) is a leading microvascular complication of diabetes mellitus and an important cause of preventable vision loss. While biological risk factors are well established, evidence regarding the contribution of behavioural and health-care access factors to DR among patients managed at primary health care facilities in Vietnam remains limited.

Objective: To identify factors associated with diabetic retinopathy among patients with type 2 diabetes managed at primary health care facilities in Nghe An Province.

Methods: A cross-sectional analytical study was conducted among 360 adults aged ≥40 years with type 2 diabetes receiving routine management at primary health care facilities in three representative districts of Nghe An Province in 2023. All participants underwent comprehensive ophthalmic examination, including dilated fundus examination using slit-lamp biomicroscopy with a Volk 90D lens. Factors associated with DR were evaluated using univariate and multivariable logistic regression analyses. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were reported.

Results: Multivariable logistic regression identified independent associations between DR and poor glycaemic control (HbA1c ≥7.0%; aOR=2.1, 95% CI: 1.2–3.4), diabetes duration ≥10 years (aOR=2.6, 95% CI: 1.5–4.3), lack of regular eye examinations (aOR=2.8, 95% CI: 1.6–4.9), distance to the nearest health-care facility ≥20 km (aOR=1.9, 95% CI: 1.1–3.2), and poor awareness of diabetic retinopathy (aOR=1.7, 95% CI: 1.01–2.8). Ethnicity was not independently associated with DR after adjustment for potential confounders.

Conclusions: Diabetic retinopathy among patients with type 2 diabetes managed at primary health care facilities was independently associated with biological factors (poor glycaemic control and longer diabetes duration), behavioural factors (lack of regular eye examinations and poor awareness), and health-care access barriers (long distance to health-care facilities). These findings provide evidence for risk-stratified diabetic retinopathy screening and integrated diabetes management at the primary health care level.

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