Diabetes Burden and Healthcare Barriers Among Cataract Patients in Imo State, Nigeria.

Abstract

Background: The coexistence of diabetes and cataracts increases the risk of poor surgical outcomes. Cataract patients with uncontrolled diabetes and other comorbidities were unsafe for same-day surgery, which excluded them from free cataract surgeries during a medical mission outreach in rural Imo State, Nigeria. Objective: This study aims to identify barriers to diabetes control among cataract patients in the community, to improve health outcomes and surgical readiness in short-term medical missions. Methods: A total of 45 cataract patients aged 40-94 years received point-of-care testing for fasting blood sugar, intraocular pressure (IOP), and hemoglobin levels. Structured questionnaires assessed socio-economic status (SES), diabetes burden, and barriers to care. Findings: Despite reported adherence to daily medications (p = 0.0007), many patients had high diabetes burden scores, which were significantly associated with frequent symptoms (p < 0.00003), and more chronic diseases (p < 0.008). Elevated IOP, a glaucoma risk factor, was linked to private drinking-water sources (p = 0.008), and herb use was associated with lower hematocrit (p = 0.040), suggesting anemia risk. Lower hematocrit further correlated with more advanced cataracts (p = 0.018). High barriers-to-care scores were associated with the absence of a caregiver (p = 0.005), limited food choices (p < 0.001), the frequency of medical checks (p < 0.001), and a patient's medication source (p = 0.030). Patients who struggled with transportation barriers reported needing help with daily tasks like going to the market or cooking meals (p = 0.004). Conclusion: Disease severity in cataract patients is influenced by overlapping medical, financial, and social barriers. Providing tools for effective diabetes self-monitoring and mitigating comorbidities through community-tailored interventions can improve health stability and future surgical access in this rural community.