Background: Diabetes mellitus (DM) and its complication present a major morbidity burden among Saudi population. Awareness and proper knowledge of this highly prevalent disease is crucial to enhance early detection and proper intervention. Therefore, the main aim of this study was to identify the knowledge, attitude, and practices (KAP) of diabetic patients towards diabetes and diabetic retinopathy in Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted in 50 randomly selected primary care centers and two university hospitals in Riyadh, Saudi Arabia, between May and December 2018. Diabetic patients >= 18 years old were enrolled in the study. A validated KAP-45 questionnaire was used to assess the KAP levels of diabetics towards diabetes and diabetic retinopathy. Results: A total of 313 participants were enrolled in the study. The majority were males 168 (59.8%). The median age was 49 +/- 24, and the median duration of diabetes was 8 +/- 11 years. The average knowledge score for diabetes was 10 (good). While the average knowledge score for diabetic retinopathy was 4.5 (suboptimal). The average attitude scores for both diabetes and diabetic retinopathy were 0 and 2 (suboptimal), respectively. The average practice score for diabetes was 5 (good) while it was 3 (low) for diabetic retinopathy. The most common barrier to comply with regular follow-up was inadequate knowledge about the importance of periodic eye exam 47.1% (107). Patients with low socio-economic status had a significantly poor knowledge regarding diabetes (P< 0.0001) and diabetic retinopathy (P< 0.015), respectively. However, patients with low educational level had a significantly poor knowledge (p< 0.0001) and poor practice regarding diabetes (P< 0.013), respectively. Conclusion: It is important to improve education and awareness of DM and diabetic retinopathy among diabetics, as it's essential for controlling the disease and reducing its complications, by improving patient compliance to treatment and follow-up.

Diabetic retinopathy (DR) is a serious cause of irreversible blindness and is the most common complication of diabetes. Annual fundus examination for diabetics aids in the prevention of blindness and allows intervening at a timely manner. As primary care physicians (PCP) are the main providers for diabetic care in Saudi Arabia, we aim to evaluate the current knowledge and awareness, and to assess practices among PCP regarding DR. We conducted a cross-sectional study covering 46 randomly selected primary-care centers in Riyadh during October 2015. A Self-administered questionnaire was distributed to PCP containing 3 sections. The first section covered participants' demographics and professional background. The second section contained multiple-choice questions on knowledge related to diabetes and DR. The third section was to assess physicians' practices. A total of 216 PCPs completed the questionnaire. The mean overall knowledge score was 57 ± 14 out of 100. There was a significant difference in knowledge score between physicians who had obtained a subspecialty degree in family medicine compared to others (59 ± 14, 53.3 ± 14 respectively; P = 0.003). Only 19% of PCPs were aware of anti-vascular endothelial growth factor (VEGF) injections as a modality of treatment. A defect was found in the screening and follow-up of type 1 diabetics, and only 24% of physicians correctly referred patients with type 1 diabetes to an ophthalmologist. Our study uncovered areas of defects in knowledge among PCP regarding DR. This needs to be addressed in future seminars and workshops with an emphasis on the proper ophthalmological screening and management of diabetic patients.

Diabetic retinopathy (DR) is one of the major complications of diabetes mellitus (DM) and the leading cause of blindness among adults. However, adherence to diabetic retinopathy screening (DRS) significantly reduces blindness. A substantial proportion of diabetics have suboptimal compliance to DRS, which inversely affects their outcomes. Therefore, the aim of this study is to determine the level of adherence to DRS and to explore the factors possibly associated with poor adherence to regular screening among diabetics in Riyadh, Saudi Arabia. A cross-sectional study was conducted that encompassed 404 adult diabetic patients attending outpatient clinics in four hospitals in Riyadh. A validated, self-administered questionnaire was used for data collection that included five main sections: sociodemographic data, diabetic profile, assessment of knowledge about DR, attitude toward DRS, and barriers to DRS. Data were analyzed by SPSS, version 23 (IBM Corp., Armonk, NY); qualitative variables were described as percentages, and quantitative variables were described as means ± standard deviation (SD). We used the chi-square test to measure the associations between qualitative variables and binary logistic regression analysis to predict the independent barriers to DRS. The average age of the participants was 54 years, and 69.1% were females. The average duration of diabetes was 12.3 years. Type 2 DM was the most prevalent form of DM (63.6%). DR was reported by 20% of participants. Poor knowledge about DRS was prevalent in 51%. More than one-fifth were never screened for DR. About one-third of participants agreed that cost was an important contributing barrier. Adequate knowledge, increased duration of diabetes, and presence of neurological complications increased independent adherence to screening. One-fifth of participants reported having DR. Half the participants had poor knowledge about DR, which formed a major barrier against regular screening. However, most participants had positive attitudes about DR screening. Therefore, intervention strategies to increase patients’ awareness of DR might be the cornerstone of ensuring proper adherence to DRS.

Purpose: Tele-retinal screening programs use a nonmydriatic camera for retinal imaging. These images are reviewed by ophthalmologists, for interpretation and planning of appropriate treatment and follow up. Patient satisfaction is a critical tool to assess the quality of healthcare delivery and to reframe the current screening programs. The aim of this study is to measure satisfaction toward a tele-retinal screening program among diabetics attending endocrinology clinics at a tertiary hospital in Riyadh. Methods: This is a cross-sectional study that included a total of 163 patients recruited while attending tele-retinal screening at King Abdul-Aziz University Hospital in Riyadh, during the period between May and August 2019. A self-administrated Patient Satisfaction Questionnaire PSQ18 was used which included demographic data, diabetes history, and seven domains of satisfaction that were measured. Results: Some 54% of the respondents were male. The average age was 44.8 years. Some 49.7% had type 2 diabetes. The mean duration of diabetes was 15.3 years. The overall satisfaction level was 80.4%. The highest satisfaction rate was in the interpersonal manner (mean 4.45) while the lowest was in accessibility to an ophthalmologist when a referral was needed (mean 3.01). Some 60% of the participants were concerned it might take a long time to be referred to an ophthalmologist when it is needed. Some 90.1% found it easier to have diabetic retinopathy (DR) screening during routine diabetes follow up. Some 23.9% did not like the idea of only seeing the ophthalmologist when it is necessary and only 9.8% had some doubts of the doctor’s ability to diagnose DR by evaluating retina photos only. No significant association was found between patient’s satisfaction and demographic background or diabetes history. Conclusion: Patients were found to be highly satisfied with tele-retinal screening program. Mostly the reason of dissatisfaction was found in accessibility to an ophthalmologist when a referral was needed. Therefore, it is important to reassure patients that timely referral for effective intervention is performed and part of the screening policies.

Diabetic retinopathy (DR) is considered the fifth leading cause of visual impairment worldwide and is associated with a huge social and economic burden. Describe the practicality of non-mydriatic funduscopic screening photography for the detection of DR among patients with type 1 and type 2 diabetes. Cross-sectional hospital-based study. Diabetes center, Riyadh. Between July and December 2017, patients with diabetes and aged ≥18 years were selected by systematic random sampling from the University Diabetes Center. Fundoscopic eye examination was performed using the TRC-NW8 non-mydriatic camera, which performs ocular coherence tomography (OCT) to detect macular edema. Using telemedicine, pictures were graded by a retinal-specialized ophthalmologist using the international clinical DR disease severity scale. Patients were classified according to the type and severity of DR. Detection and classification of DR. 978 Saudi patients with diabetes. Of 426 (43.5%) patients with DR, 370 had nonproliferative DR and 55 had proliferative DR. Nineteen (1.9%) had macular edema. The most important risk factors for DR were longer diabetes duration and poor glycemic control. Both older age and insulin use contributed to the higher prevalence of DR and macular edema. DR was more common among type 1 patients at 55.4% compared with 49% among type 2 patients. In addition, more females had macular edema (57.1% versus 42.9% among males). Nine patients with macular edema (47.3%) had hypertension while 154 of 426 patients with DR (36.2%) had hypertension. Non-mydriatic funduscopic screening photography was practical and useful for the detection of DR in patients with type 1 and type 2 diabetes. Conducted in a single center. None.