The study was done to assess knowledge of diabetes and acceptance of eye care among people with diabetes in rural China, to improve service uptake.

Population-based study of people in Guangdong, China, with glycosylated haemoglobin A1c≥6.5% and/or known history of diabetes. Participants answered a questionnaire on medical history, demographic characteristics, self-rated health and vision, knowledge about diabetes and diabetic retinopathy, quality of local healthcare, barriers to treatment, likely acceptance of eye exams and treatment, and interventions rated most likely to improve service uptake.

562 people had diabetes, 22.3% previously diagnosed. ‘Very likely’ or ‘likely’ acceptance of laser treatment 26.4% was lower than for eye exams. Predictors of accepting both exams and laser included younger age (p<.001) and prior awareness of diabetes diagnosis (p=0.004 and p=0.035, respectively). The leading barrier to receiving diabetes treatment was unawareness of diagnosis 97.2%, while interventions rated most likely to improve acceptance of eye exams included reimbursement of travel costs 73.0%, video or other health education 67.7% and phone call reminders 65.3%.

The study concluded that the improving diagnosis of diabetes, along with incentives, education and communication strategies, is most likely to enhance poor acceptance of diabetic eye care in this setting.