The article “Impact of individual counseling on the knowledge and attitudes of type 2 diabetics regarding diabetic retinopathy: The Aditya Jyot Diabetic Retinopathy in Urban Mumbai Slums Study – Report 3” is a good endeavor in education of the masses to help in prevention of blindness. The higher strata of society are in an advantaged position to have good schooling and knowledge and also availability and access to health services. But the people living in slums have no proper health education or access to specialized health-care services.
We all know that diabetic retinopathy (DR) carries a significant morbidity and can affect the livelihood of a person. Broadly speaking, the interventions in DR are patient education, annual screening, and then treating DR by using laser, anti-vascular endothelial growth factor (anti-VEGF) injections, or vitreo retinal (VR) surgical maneuvers in latter stages.
In many developed countries, the program of diabetic screening (annual or more frequent) according to the risk helps identify significant changes which can be tackled at an early stage, and hence, a significant impact on the individual and health system as a whole can be prevented.
We all are aware of the age-old dictum, “prevention is better than cure.” This article advocates the same and shows the results of such patient education with statistical evidence.
If a population can be educated, then the knowledge percolates horizontally and vertically through the society and as shown in this article, it can lead to significant improvement in the quality of sight and life.
The design of the study is simple, but statistically relevant and validated.
In my opinion, like all other screening programs run by the Government of India, screening for DR should also be carried out and education of the masses regarding end-organ damage by diabetes should be provided. This will be an economically viable proposition in the long term. This has been shown in some analyses in other countries.[1]
We all should take some time out of our busy practices to serve the lower strata of the community around us, so that we can pay back the society a fraction of what they give us as respect and financial reward.
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Conflicts of interest
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Reference
1. Javitt JC, Aiello LP. Cost-effectiveness of detecting and treating diabetic retinopathy Ann Intern Med 1996;124:164–9.
