Rural-urban disparities in the prevalence of diabetes and diabetic eye complications in Hungary

Background To examine the rural-urban differences in the prevalence of diabetes mellitus (DM) and diabetic retinopathy (DR) in the population aged 50 years and older in Hungary. Methods 105 clusters of 35 people aged 50 years or older were randomly selected. Standardized rapid assessment of avoidable blindness (RAAB) with the diabetic retinopathy module was performed. Participants were classified as diabetic if they had a previous diagnosis of DM or a random blood glucose level >= 200 mg/dl. Each individual with DM who agreed underwent dilated fundus examination and DR grading. Results The prevalence of DM was higher in rural (21.8%) than in urban (18.6%) areas (p = 0.016). The prevalence of DR did not differ significantly between rural and urban areas in DM cases. Blindness (0.9% vs. 0.1%; p = 0.048) and blindness due to DM (0.3% vs. 0.0%; p = 0.021) in diabetic participants was significantly more common in rural than in urban areas. Diabetic eye screening coverage was significantly lower in rural than in urban areas (p <= 0,007). Conclusion Based on our results and the high rate of blindness and blindness due to DR in rural areas, primary eye care should be improved and a telemedical eye screening program should be undertaken, especially concentrating on rural areas.