AIM OF THE PROJECT
- Screening of normal population for diabetes to avoid all complications related to diabetes.
- Screening of diabetic patients to detect diabetic retinopathy, to detect early changes and provide prompt treatment to decrease rate of vision loss and blindness.
- To increase awareness of disease among people, health professionals and workers.
Subsequently, World Diabetes Foundation, Denmark has appraised the project, and is now providing much needed financial and technical aid. Together, we strive to achieve the following goals in a span of five years ( Feb 2008 to Feb 2013 ) :
- Screening of 100,000 people for diabetes.
- Screening of 75,000 cases of diabetic retinopathy.
- Treatment of 7,500 cases of diabetic retinopathy.
- Training of 500 link and social workers.
- Education of 500 intern doctors.
Diabetic retinopathy screening program is an effort of team of personnel, which involves ophthalmologist, optometrist, Lab. Technician, community health workers, health counsellers, voluntary organizations like Samvedana Trust, Lion’s Club, Nagri Eye Research And Foundation, World Diabetes Foundation.
Screening protocol :
- Random blood sugar levels
- Associated systemic assessment
- Ocular assessment
- Anterior segment evaluation
- Fundus examination
Investigations :
Glycosylated hemoglobin, Blood sugar levels: fasting & postprandial Renal function test, Lipid profile, Microalbuminuria
Patient counselling :
Referral to diabetologist.
Referral to Nagri Eye Hospital for ocular investigations and treatment
PHASE 1 : (1.1.2007 – 31.12.2007)
- Screening of known diabetic patients at four municipal corporation hospitals in Ahmedabad. Nagri Hospital , V.S. Hospital , L.G. Hospital , S.C.L. Hospital
- 9 wards : CENTRAL ZONE : Shahpur, Dariyapur, Khadiya, Jamaalpur, Kalupur, Rakhiad, Madhupura, Girdharnagar, Dudheshwar.
- Screening of normal population for diabetes and diabetic retinopathy by organizing camps.
|
CAMPS during Phase 1 (1st JAN"2007 to 31st DEC"2007)
|
|
NO.
|
DATE
|
PLACE |
DIABETIC
|
NON-DIABETIC
|
TOTAL
|
|
1
|
21/1/2007
|
(KHADIYA) |
65
|
62
|
127
|
|
2
|
25/2/2007
|
(MADHUPURA) |
18
|
59
|
77
|
|
3
|
11/3/2007
|
(SHAH PUR) |
69
|
148
|
217
|
|
4
|
8/4/2007
|
(JAMALPUR) |
57
|
187
|
244
|
|
5
|
22/4/2007
|
(DUDESHWAR) |
30
|
130
|
160
|
|
6
|
20/5/2007
|
(KALUPUR RILIF ROAD) |
16
|
29
|
45
|
|
7
|
17/6/2007
|
(RAIKHAD) |
53
|
126
|
179
|
|
8
|
24/6/2007
|
(DARIYAPUR) |
35
|
89
|
124
|
|
9
|
22/7/2007
|
(DARIYAPUR, Becharda) |
37
|
137
|
174
|
|
10
|
13/8/2007
|
(BAREJA) |
9
|
106
|
115
|
|
11
|
2/9/2007
|
(RANIP GAYATRI TEMPLE) |
75
|
128
|
203
|
|
12
|
3/9/2007
|
(CAMP CHANDKHEDA) |
6
|
112
|
118
|
|
13
|
29/9/2007
|
(DUDESHWAR) |
10
|
19
|
29
|
|
14
|
30/9/2007
|
(ASARWA) |
51
|
178
|
229
|
|
15
|
23/10/2007
|
(SHAHPUR) LIONS CLUB |
20
|
56
|
76
|
|
16
|
28/10/2007
|
(SHAHIBAUG ( LIONS CLUB) |
28
|
106
|
134
|
|
17
|
23/12/2007
|
(UTTHKANTESHWAR) |
18
|
495
|
513
|
PHASE 2: 1.1.2008 – 31.12.2008 (in progress)
Screening of known diabetics at urban health centres (EASTERN ZONE)
| DAY |
URBAN HEALTH CENTRE |
| Monday |
Ramol + L G Hospital |
| Tuesday |
Rakhiyal + Gomtipur |
| Wednesday |
Nikol + Odhav |
| Thursday |
Khokhra - Memdavad |
| Friday |
Hatkeshwar + Amraiwadi |
| Saturday |
V S General Hospital |
- Screening of known diabetic patients at four municipal corporation hospitals in Ahmedabad.
- Screening of normal population for diabetes and diabetic retinopathy by organizing camps.
|
CAMPS during Phase 2 (1st JAN"2008 to 31st JUL"2008)
|
|
NO.
|
DATE
|
PLACE |
DIABETIC
|
NON-DIABETIC
|
TOTAL
|
|
1
|
24/2/2008
|
(NIKOL) |
9
|
63
|
72
|
|
2
|
30/3/2008
|
(GOMTIPUR) |
8
|
54
|
62
|
|
3
|
30/3/2008
|
(SARDAR NAGAR) |
71
|
189
|
260
|
|
4
|
13/4/2008
|
(ODHAV) |
11
|
71
|
82
|
|
5
|
20/4/2008
|
(CENTRAL JAIL) |
113
|
153
|
266
|
|
6
|
27/4/2008
|
(S.C.L. Hospital) |
122
|
411
|
533
|
|
7
|
11/5/2008
|
(BHAIPURA U.H.C.) |
7
|
37
|
44
|
|
8
|
18/5/2008
|
(CENTRAL JAIL) |
20
|
357
|
377
|
|
9
|
24/5/2008
|
(RAMOL U.H.C.) |
1
|
40
|
41
|
|
10
|
25/5/2008
|
(AMRAIWADI U.H.C.) |
11
|
54
|
65
|
|
11
|
26/5/2008
|
(KAKADIYA HOSPITAL) |
18
|
143
|
161
|
|
12
|
1/6/2008
|
(CENTRAL JAIL) |
11
|
111
|
112
|
|
13
|
8/6/2008
|
(RAKHIYAL U.H.C.) |
38
|
8
|
46
|
|
14
|
15/6/2008
|
(CENTRAL JAIL) |
35
|
222
|
257
|
|
15
|
22/6/2008
|
(KHOKHRA U. H. C.) |
6
|
15
|
21
|
|
16
|
6/7/2008
|
(RAMOL U.H.C.) |
21
|
282
|
303
|
RESULTS
Total number of patients examined from 1st jan 2007 to 31st jul 2008 :
| YEAR |
TOTAL |
DIABETICS |
| JANUARY to DECEMBER 2007 |
20278 |
5473 |
| JANUARY to JULY 2008 |
23,224 |
4665 |
| TOTAL |
43502 |
10138 |
| HOSPITAL |
TOTAL |
| V. S. Hospital |
4627 |
| S. C. L. Hospital |
3462 |
| L. G. Hospital |
3599 |
| Nagri Eye Hospital |
23326 |
| Urban Health Center |
2897 |
| CAMP |
5476 |
| PALDI |
115 |
| TOTAL |
43502 |
Total number of camps organized (1st jan 2007 to 31st july 2008) : 33
| Diabetics |
1069 |
| Non diabetic |
4407 |
| Total |
5476 |
| Diabetic Screening project |
Total |
| General Population screened for diabetes mellitus |
43,502 |
| No. of Newly detected diabetics |
517 (5.10%) |
| No. of known diabetics |
9621(17.90%) |
| Total No. of Diabetic Patients detected |
10138 /43,502 (23%) |
| Diabetic retinopathy screening project |
| No. of Diabetic Patients underwent Dilated Eye exam |
10,138 |
| No. of newly detected Diabetics who underwent eye exam |
883/10,138 |
| No. of DR patients in newly detected group |
58/883 |
| Prevalence of diabetic retinopathy in newly detected diabetics |
6.56% |
| No. of known diabetics who underwent eye exam |
9,255/10,138 |
| No. of DR patients in known diabetic group |
1,905/9,255 |
| Prevalence of diabetic retinopathy in known diabetics |
20.58% |
| Total no. of Diabetic Retinopathy patients |
1963/10138 |
| Prevalence of Diabetic Retinopathy |
19.36% |
| NPDR |
80.64% |
| PDR |
13.49% |
| ADVANCED PDR |
06.72% |
| CSME |
11.76% |
TREATMENT
Laser therapy : 786 sittings
Intravitreal injections (triamcinolone, bevacizumab) : 124 eyes
Surgery : 93 eyes.
DIABETES AWARENESS PROGRAM
Community level :
- All patients are supplied with leaflets explaining the diabetes and its systemic complications, in pictographic form and local language.
- Health counsellers have been appointed at all the screening clinics.
- Educational and training programs at rural health canters.
Tertiary health care level :
- Educational programs for medical and paramedical staff at AMC hospitals.
- Training of optometrist, nursing staff and interns by conducting didactic lectures.
- CME program at CH Nagri Eye Hospital.
PREVENTIVE MEASURES
Prevention is better than cure
- Prevention of diabetic retinopathy requires prevention of diabetes
- Patients at higher risk (i.e. family history, ethnicity) of developing diabetes can adjust modifiable risk factors like Healthy diet, Exercise, Blood pressure control, Tobacco cession, Weight reduction.
Diabetes and Eye
A symposium has been organized by Nagri Eye Research Foundation on Diabetes and Eye in April, 2008. The Aim was to convey the importance of retina examination in diabetic patients. Around 95 ophthalmologists attended the seminar. Various important aspects of diabetes and diabetic retinopathy were discussed by endocrinologist and ophthalmologists. The newer aspect of treatment of diabetic retinopathy was also discussed by vitreoretinal surgeons. Dr. Vatsal Parikh from Mumbai and Dr. Rajeev Raman From Chennai gave lot of information regarding the disease.
