title: Regular visits to a diabetes clinic were associated with lower magnitude of visual disability and diabetic retinopathy-a hospital-based historical cohort study in yemen.
abstract: BACKGROUND
  We associated regularity in visits to a diabetes clinic with the presence of diabetic retinopathy (DR) and visual disabilities.
  
  
  METHODS
  This historical cohort study was conducted in 2004. The physician reported details of diabetes mellitus (DM), hypertension, and other illness. The ophthalmologist examined eyes and noted visual acuity, DR, and other ocular morbidities. We calculated the relative risk (RR) of different complications of diabetes.
  
  
  RESULTS
  Our cohort consisted of 228 patients (114 in each group, one that attended diabetes clinics regularly [group A] and one that had irregular attendance [group B]). DR was found in 47 (41.2%) and 68 (61.4%) patients, respectively. The risk of DR was significantly higher in group B (RR = 1.51, 95% confidence interval [CI] 1.23 to 2.18). The severity of DR was also positively associated with irregularity in clinic visits (x(2) = 33.56, degrees of freedom = 5, P = 0.000003). The risk of bilateral blindness (RR = 4.0, 95% CI 1.38 to 11.6) and low vision disability (RR = 2.53, 95% CI 1.84 to 3.47) were higher in group B. The duration of diabetes and the regularity in clinic visits were the predictors of DR.
  
  
  CONCLUSIONS
  The presence of DR and visual disabilities among patients with diabetes is associated with irregular attendance at diabetes clinics. The regularity of medical visits seems to be a proxy indicator of better primary prevention of eye complications of DM.
authors.affiliation: Department of Ophthalmology, Sana'a University, Yemen.
authors.forename: Mahfouth A
authors.initials: MA
authors.lastname: Bamashmus
authors.forename: Abdallah A
authors.initials: AA
authors.lastname: Gunaid
authors.forename: Rajiv
authors.initials: R
authors.lastname: Khandekar
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012306:Risk; D012720:Severity of Illness Index; D014786:Vision Disorders / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D015006:Yemen