Awareness of Diabetic Retinopathy Among Known Diabetics

Background and objective Diabetic retinopathy (DR) is the leading preventable cause of irreversible blindness in working-age adults worldwide. In Pakistan, with over 30 million people living with diabetes, specific patient awareness of DR as a distinct screenable complication remains poorly studied, particularly in urban tertiary care settings. The objective of this study is to determine the prevalence of specific DR awareness among known diabetic patients at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, and to identify independent sociodemographic and clinical predictors using binary logistic regression. Methods A cross-sectional study was conducted among 430 known diabetic patients (≥18 years) attending the outpatient departments of PIMS following IRB approval. An interviewer-administered, Urdu-translated, pilot-tested structured questionnaire was used. The primary outcome (primary outcome composite) defined specific DR awareness as correctly identifying DR, not cataract or glaucoma, as the primary ocular complication of diabetes. Bivariate associations were assessed by chi-square (Pearson or likelihood ratio as appropriate) and independent-samples t-tests. A binary logistic regression model identified independent predictors. Results Only 66 patients (15.3%) demonstrated specific DR awareness, despite 78.4% knowing that diabetes affects the eyes, a gap of 63.1 percentage points. Social media use was the sole independent predictor in the logistic regression (overall Wald χ² = 16.745, df = 4, P = 0.002): YouTube users OR = 3.31 (95% CI 1.44-7.62, P = 0.005); WhatsApp OR = 3.01 (95% CI 1.30-6.94, P = 0.010); and Facebook OR = 4.93 (95% CI 1.98-12.24, P = 0.001). Education showed borderline bivariate significance (likelihood ratio P = 0.047) but was not independently significant after adjustment (P = 0.477). Disease duration, gender, age, and HbA1c were all nonsignificant. Conclusions Specific DR awareness is critically low at 15.3%. Social media engagement is the only independent predictor identified. Targeted digital health campaigns delivering validated DR-specific education through YouTube, WhatsApp, and Facebook, combined with structured counseling at routine diabetic reviews, are urgently needed to bridge the awareness gap and prevent avoidable blindness.