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Diabetes and diabetic retinopathy

People from low and middle income countries, and from minority ethnic groups in the UK have a significantly higher risk of diabetes compared to Caucasians. Our research has also shown that these groups have much higher risk of preventable blindness due to diabetes.

Working with more than 4200 patients in the UK and in low and middle-income countries including India, Thailand, Nepal, China, Mexico, Pakistan, Bangladesh, Trinidad, Sri Lanka, Ghana and Nigeria, we have developed a program of research, and culturally and linguistically appropriate educational intervention to reduce this high risk of blindness.

Diabetes affects over 463 million people globally. Diabetic retinopathy is a serious complication of diabetes that can lead to blindness if undiagnosed and untreated. It is a leading cause of reversible blindness in the global working population.

Significant risk factors for diabetic retinopathy include age, duration of diabetes, high blood sugar and cholesterol levels, high blood pressure, low diabetic literacy levels, and unhealthy lifestyle choices.

While it is not possible to have much influence on age and duration of diabetes, there is a lot we can do about the control of diabetes.

It is also very important that patients attend screening for retinopathy, even if they appear to have good vision. Timely detection/treatment of diabetic retinopathy can decrease the risk of blindness by up to 90%.

Our research

Our research showed higher levels of sight-threatening diabetic retinopathy in these groups linked to poor health literacy, language barriers, and lower uptake of retinal screening.

Our team also demonstrated that different barriers to diabetic control exist in different demographics (for example, age, literacy, gender, culture) and that a 'one size fits all' intervention does not work efficiently.

This research has led to: (i) the development and dissemination of evidence-led, culturally and linguistically appropriate awareness and lifestyle interventions by policy makers and community organisations; and (ii) change in patient care practices by healthcare professionals.

Prof Shahina Pardhan and her team, with the help of a large number of healthcare providers developed and disseminated evidence-led, culturally and linguistically appropriate diabetic and diabetic retinopathy awareness workshops (in Hindi, Urdu, Nepali, and English) in collaboration with a number of stakeholders from UK, Nepal and India.

These have led to behaviour change and improved outcomes in more than 150,000 people to date in the UK and in other parts of the world evidenced by an 87–98% uptake of retinopathy screening from a baseline of 20–36%, and a significantly reduced risk of blindness.

Prof Pardhan and her team’s work has formed impact case studies for the REF2014 (which was rated as 100% "world-leading" and "internationally excellent") and REF2021.

Visit our ARUDRAPP page to see our international partnerships.