Method: Retinopathy and Blindness in Relation to Diabetes

Diabetes is a condition that affects a significant percentage of the global population. According to the World Health Organization (2014), approximately 442 million people had been diagnosed with diabetes globally, across all age groups. It is a chronic disease that affects both adults and children and has an array of complications that affect optimal functioning in its victims. Diabetic retinopathy is one of the most common visual complications of this condition, and although it is one of the rare ones, it has serious implications. If untreated, retinopathy has the potential to cause visual impairment or total blindness. 

About 75% of all people with diabetes who have had the conditions for 20 years will develop retinal complications because the risk increases with the advancement of the disease. The prevalence of retinopathy and consequently blindness in diabetes patients is expected to rise due to an increasing number of diabetes patients on a global scale. The prevention of retinopathy and therefore blindness is easy as long as it is presented in its early stages. Currently, there exist surgical and medical procedures that prevent the advancement of diabetic retinopathy. This study was meant to measure the level of diabetic prevalence, the occurrence of retinopathy in these cases and associated risk factors. The findings were intended to assist in formulating a feasible and informed method of creating awareness and reducing instances of retinopathy and blindness in diabetic patients. 

A systematic review of research conducted within the past one year was conducted for this study. This time range was selected in order to get the most recent data on the topic. The materials selected were both qualitative and quantitative research reports in the field of diabetic retinopathy with information about prevalence, diagnosis, progression, treatment responses, and risk factors. The review was limited to the USA because the factors influencing aspects such as medical care are measurable to reduce variability. Six categories were identified into which data from each study were grouped. They were; type 1 diabetes, type 2 diabetes, the recorded prevalence of diabetic retinopathy, associated risk factors, treatment options, and recommendations. Systematic reviews are commonly used in medical research because they give accurate data on conditions that have already occurred without causing harm to human beings involved in the study. They also take less time as compared to quantitative research methods. Most studies on diabetes and retinopathy analyze patient data over long periods of time to derive their conclusions. Systematic reviews and meta-analysis are also frequent in this field studies on this topic have been focused and are efficient when one cannot get easy access to raw patient information. 

This study assumed that even in particular locations, people with diabetes had varying trends in regarding the progression of the disease such as lifestyle, genetics and medical care and this influenced the probability of the onset of retinopathy. The study also assumed that the level of advancement of retinopathy in the cases reviewed was based on the certified medical protocol for diagnosing retinal complications, therefore, unknown practices were not an expected encounter in this assessment. 

Participants 

The U. S is an industrialized country, and there is a high prevalence of type 2 diabetes caused by sedentary lifestyles. This study used literature that did not discriminate between type 1 and type 2 diabetes because they are both be related to the occurrence of retinopathy. Studies about non-diabetic retinopathy and other visual complications were eliminated from the review because the focus was primarily on diabetic retinopathy. Articles comparing urban and rural populations were also included to identify distinguishing risk factors between the two groups. There was no age discrimination because the condition affects people from varying age groups including children. 

Materials 

All articles were selected from the US National Library of Medicine database. The PMC database was used and search terms were diabetic retinopathy, in the U. S. and limiters used were the time within the past one year and researches funded by the Center for Disease Control and National Institute of Health as they are trusted institutions. 

Design 

The systematic review was conducted in five steps. 

Step 1 involved framing the research question which was done by defining the problem in precise questions before beginning the work. The questions were made flexible to allow any necessary changes in the course of the review. The questions set for this study were; to what extent does diabetic retinopathy cause visual impairment? What are the associated risk factors? Does the type of diabetes affect the prevalence of retinopathy? What are the possible interventions? 

Step 2 was to identify relevant articles for the review. The US National Library of Medicine provided a variety of reports for review as it allows access to numerous articles from different databases. It also allows one to apply limiters and expanders to narrow down the search to the items that are relevant to the required topic and time frame. The search produced many articles that had to be reviewed to determine the relevant ones as per the identified variables. 

Step 3 was assessing the quality of the studies. Step one and two should provide the minimum inclusion and exclusion criteria that qualify an article for the review. This stage is meant to further refine each item by reading through it to determine whether it answers the research question. Heterogeneity and its sources are also identified in this step. 

Step 4 involved analyzing and summarizing the evidence found in the review. The first stage of this was tabulating relevant information from each article into the six categories mentioned earlier in this report. A summary of the data was then done to identify differences between studies and combine their effects. 

Step 5 is interpreting the findings where any issues flagged in any of the other stages were defined, and related biases explored. This helped to determine whether the summary of the conclusions of the review could be trusted and if not, how this can be fixed in future studies. The findings are discussed and explained, and any recommendations that could help address the problem based on the strengths and weaknesses of the findings were extrapolated. 

Procedure 

This research project began with the identification of the problem, retinopathy and blindness in relation to diabetes, and determining whether it was significant enough to focus a study on. A review of literature in this field revealed that if not addressed, retinopathy caused the majority of visual impairment and blindness cases in diabetes patients despite the availability of medical interventions to prevent this. The problem was narrowed down to specific risk factors and late presentation. The table below details the timeline for this study.