Evaluating the Effectiveness of Proactive Diagnosis and Coordinated Care Strategies in Preventing Diabetic Retinopathy in Middle-Aged Men with Sedentary Lifestyles in Urban Settings

Abstract

Due to diabetes and its complications, retinopathy remains the world’s primary cause for disability among adults aged 20 to 65 years. This disorder of the eye develops due to oversustained blood sugar levels as a result of diabetes mellitus type 1 or type 2, causing harm to the blood retina barrier, which induces blindness at its peak stage (Diabetes Foundation). Diabetic Retinopathy (DR) has multiple stages starting with non-proliferative diabetic retinopathy (NPDR) which is characterized by the presence of small bulges in the blood vessels, also known as microaneurysms along with bleeds, to proliferative diabetic retinopathy (PDR) which shows new blood vessels forming and endowing with substantial loss of eyesight. Blinded men aged 40 to 60 years residing in metropolitan areas carry the heaviest diabetes retinopathy burden globally because their diabetes is unquestioningly brought upon by a sedentary lifestyle and late detection. Living in cities promotes high rates of physical inactivity, poor nutrition, high stress, and other factors that multiply the chance of developing diabetes and having eye problems. Other barriers to tackle these problems include lack of healthcare services, unawareness of the condition, and inadequate health policies. Along with all these barriers, this segment of the population, due to work, spends more time away from home than for their health, allowing the diabetes-associated complications to develop and progress unchecked. An integrated and proactive care model has the potential to slow or even halt the progression of diabetic retinopathy (DR). In particular, through employing regular ophthalmic assessments and advanced screening techniques. For instance, an urban population of middle aged men exhibited a decrease in DR progression by 35% when there was optimal glucose management along with lifestyle changes. In addition, there is data, supporting previously held beliefs, that strict blood glucose control lowers the risk of DR progression by around 75%. Furthermore, increasing levels of physical activity and maintaining a well-balanced diet helps diabetic patients with retinopathy subsequently decreasing the incidence of diabetic retinopathy. The landscape of DR diagnosis has profoundly evolved with the use of technology, in particular through the introduction of teleophthalmology and AI powered retinal imaging. AI can pick up early signs of retinal damage more accurately and more effectively than human health care workers can, thus improving DR diagnosis in underserved urban areas. AI screening also increased rates of diabetic retinopathy diagnosis by 35% which allows for timely and much needed treatment. Unfortunately, the effective management of DR continues to be profoundly hampered by systemic issues. DR prevention is hindered by a predominately sedentary lifestyle stemming from overpopulated cities with long working hours and few avenues for exercise. The problem is worsened by the unequal distribution of health care resources as it further puts a strain on vulnerable communities and populations by making it difficult for these groups to access adequate health care services at the appropriate time. Policies need to be put in place that subsidize screening programs, public awareness campaigns, and eye health within primary care to address these issues. This research suggests that community based screening, patient outreach, multidisciplinary care, and more supportive public policies-focused on prevention-should be implemented. The research further suggests a shift in approach to comprehensive health care, arguing that individual and public health can be improved in a more proprietary manner which helps the at risk urban population to build more resistance to diabetic retinopathy.