05900983

October 27, 2023, 18:12

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Author Details: First Author and Corresponding Author: Dr. Prasanna Venkatesh Ramesh MBBS, MS, DNB, MNAMS, FAICO (Glaucoma), FICO (Glaucoma), Fellowship in Glaucoma Surgery and Research (Sathyan Eye Care and Coimbatore Glaucoma Foundation) Medical Officer, Department of Glaucoma and Research Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India Email: email2prajann@gmail.com 1st Co-Author: Ms. Ajanya K Aradhya B. Optom Optometrist, Department of Optometry and Visual Science Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India Email: ajanyak777@gmail.com 2nd Co-Author: Aji Kunnath Devadas B. Optom Research Optometrist, Department of Optometry and Visual Science Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India Email: ajikdevadas@gmail.com Reader Comments: Commentary on titled “Accessibility and Utilization of Healthcare Services Among Diabetic Patients: Is Diabetes a Poor Man’s Ailment?” The article titled "Accessibility and Utilization of Healthcare Services Among Diabetic Patients: Is Diabetes a Poor Man’s Ailment?" offers valuable perspectives on the difficulties associated with diabetes management and the growing need for healthcare services among individuals with diabetes. Diabetes, as the article rightly emphasizes, is a health condition that affects individuals across all social backgrounds. The prevalence of diabetes requires comprehensive healthcare services due to the associated risks of comorbidities, difficulties in maintaining glycemic control, and frequent hospitalizations.[1] In the context of this article, it's important to highlight the significance of artificial intelligence (AI) tools for assessing diabetic retinopathy, a common complication of diabetes. The utilization of artificial intelligence (AI) tools for assessing diabetic retinopathy is a significant advancement in the management of diabetes. Diabetic retinopathy, a consequence of diabetes, poses a significant risk of vision impairment and potential blindness when not promptly identified and managed. Innovative AI tools have been developed to support healthcare professionals in the early detection of diabetic retinopathy by analyzing eye fundus images. AI systems can detect diabetic retinopathy at its earliest stages, allowing for timely interventions and preventing vision loss. The AI tool created by us using Human-in-the-loop machine training, help in not only finding the diagnosis and the grade of the disease, but also help in detecting the intricate signs of the condition. This aligns with the overall goal of the article, which is to improve healthcare accessibility and utilization among diabetic patients. By automating the process of retinopathy screening, AI tools can potentially reduce the financial burden on patients, which is a relevant consideration in the context of the article's focus on the economics of diabetes care. AI tools can be deployed in a variety of healthcare settings, including remote and underserved areas, enhancing the accessibility of diabetic retinopathy screening services. In addition to identification and classification, the AI tool created by us is designed to pinpoint specific signs of DR, such as microaneurysms, hard exudates, dot-blot hemorrhages, and neovascularization through trained customized human annotations. Expanding the use of this innovative system globally would have a more positive impact in regions where there is a shortage of ophthalmologists and for poor patients who are not able to afford consultations and other charges. In these areas, an artificial intelligence tool can be employed. The integration of AI for the assessment of diabetic retinopathy represents a promising breakthrough in the field of healthcare. By leveraging AI, healthcare professionals can enhance the early detection of retinopathy, thereby preventing vision impairment and blindness.[2-4] In conclusion, the article underscores the importance of accessibility and utilization of healthcare services for diabetic patients, dispelling the notion that diabetes is exclusive to low-income individuals. The integration of AI tools in diabetic retinopathy assessment, especially the evaluation of fundus images, represents a noteworthy advancement in healthcare. AI-driven approaches not only assist in early diagnosis but can also contribute to cost-effectiveness and consistency in care, which is crucial for diabetic patients from various socioeconomic backgrounds. References: 1. Eseadi C, Amedu AN, Ilechukwu LC, Ngwu MO, Ossai OV. Accessibility and utilization of healthcare services among diabetic patients: Is diabetes a poor man’s ailment? World Journal of Diabetes. 2023 Oct 15;14(10):1493–501. 2. Ramesh PV, Ramesh SV, Subramanian T, Ray P, Devadas AK, Ansar SM, et al. Customised artificial intelligence toolbox for detecting diabetic retinopathy with confocal truecolor fundus images using object detection methods. TNOA J Ophthalmic Sci Res 2023;61:57‑66. 3. Akkara JD, Kuriakose A. Role of artifcial intelligence and machine learning in ophthalmology. Kerala J Ophthalmol 2019;31:150‑60. 4. Schmidt‑Erfurth U, Sadeghipour A, Gerendas BS, Waldstein SM, Bogunović H. Artifcial intelligence in retina. Prog Retin Eye Res 2018;67:1‑29.

First, thank you very much for your professional comments on the article published in World Journal of Diabetes. Second, we read your comments with great interest. You are welcome to format your valuable comments into a Letter to the Editor and submit it online to World Journal of Diabetes at https://www.f6publishing.com. There are no restrictions on the number of words, figures (color, B/W) or authors for a Letter to the Editor. In addition, the article processing charge will be exempted for this Letter to the Editor. As with all articles published by the Baishideng Publishing Group, the Letter to the Editor will be published online after completing peer review. The guidelines for a Letter to the Editor can be found at: https://www.wjgnet.com/bpg/GerInfo/219. Finally, we look forward to receiving your high-quality Letter to the Editor, which will promote academic communication and lead the development of this discipline.

05327699

October 23, 2023, 06:05

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First Author : Parul Chawla Gupta MS Ophthalmology Associate Professor Advanced Eye Centre, PGIMER, Chandigarh Email: pcgpgi@gmail.com 1st Co-Author : Mona Duggal MD Community Medicine Associate Professor (Community Ophthalmology) Advanced Eye Centre, PGIMER, Chandigarh Email: monaduggal2@gmail.com 2nd Co-Author and Corresponding Author: Arvind Kumar Morya, MS(Gold-Medalist) MNAMS Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India Email: bulbul.morya@gmail.com Commentary on titled “Accessibility and Utilization of Healthcare Services Among Diabetic Patients: Is Diabetes a Poor Man’s Ailment?” The article titled “Accessibility and Utilization of Healthcare Services Among Diabetic Patients: Is Diabetes a Poor Man’s Ailment?” is very well-written. Diabetes affects everyone, regardless of their social background. As a result, diabetes is not a disease that just affects low-income people. Diabetes patients demand more medical care services than non-diabetic patients due to their increased risk of comorbidities, poor glycemic control, and frequent hospitalisations. Despite the encouraging increase in the number of diabetes individuals seeking medical care because of increased knowledge, several personal and institutional issues continue to hinder access.1 The prevalence of diabetes among high-income earners has been linked to physical inactivity. In contrast, the prevalence of diabetes among low-income earners has been linked to poor diets and a lack of funds to manage the negative consequences of diabetic diseases. Diabetes control requires easy access to medical care providers. According to the existing research, the number of patients seeking access to medical care services has grown over time. Yet, various variables have been found in the literature that impede patient access to the available medical care services. When patients cannot receive medical care services, the fundamental goals of providing such treatments are jeopardised. As a result, the health of diabetes patients suffers, particularly in patients from low-income families in developing nations. The primary goal of all medical services is to increase the use of medical care services, and this review has shown that Diabetic patients use some of these medical care services, even though the percentage of people who use these services is negligible. The level of service is relatively poor. Diabetes medical care services are lacking in many impoverished nations, and healthcare facilities have been reported to be overstressed, particularly in low-income nations, due to increased diabetics. A cross-sectional study in Southwest China found that the prevalence of pre-diabetes and diabetes was greater among urban older persons than their rural counterparts, as they had a higher prevalence of obesity, central obesity, and physical inactivity.2 In the National Health Interview Survey, it was revealed that diabetes was more prevalent in low-income populations. Another study that studied factors influencing the utilization of healthcare services related to diabetes included a lack of information of both the disorder and the need for screening, economic reasons, institutional constraints, unavailability of syringes and testing equipment, high wait periods at eye clinics, overcrowded clinics, and fear of discomfort.3 It has been noticed that older adults with diabetes use emergency services and some outpatient visit services more than younger people. According to research done by Shalev et al., gender affects the consumption of health care services, with females with diabetes using more health care services than their male counterparts.4,5 To improve diabetes patients' access to health care services, policies and intervention programmes should be developed and focused on reducing the current barriers that impede diabetic patients' access to health care services. Both government and non-governmental organisations should focus on improving the quality of diabetes care services, basic healthcare amenities, and health-awareness programme services to facilitate the provision of efficient medical care services to diabetic patients.6,7 References 1. Eseadi C, Amedu AN, Ilechukwu LC, Ngwu MO, Ossai OV. Accessibility and utilization of healthcare services among diabetic patients: Is diabetes a poor man’s ailment? World Journal of Diabetes. 2023;14(10):1493-1501. doi:10.4239/wjd.v14.i10.1493 2. Zhao Y, Li HF, Wu X, Li GH, Golden AR, Cai L. Rural-urban differentials of prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China. BMC Public Health. 2023;23(1):603. doi:10.1186/s12889-023-15527-9 3. Piyasena MMPN, Murthy GVS, Yip JLY, et al. A qualitative study on barriers and enablers to uptake of diabetic retinopathy screening by people with diabetes in the Western Province of Sri Lanka. Trop Med Health. 2019;47:34. doi:10.1186/s41182-019-0160-y 4. Buja A, Caberlotto R, Pinato C, et al. Health care service use and costs for a cohort of high-needs elderly diabetic patients. Prim Care Diabetes. 2021;15(2):397-404. doi:10.1016/j.pcd.2020.12.002 5. Shalev V, Chodick G, Heymann AD, Kokia E. Gender differences in healthcare utilization and medical indicators among patients with diabetes. Public Health. 2005;119(1):45-49. doi:10.1016/j.puhe.2004.03.004 6. Mutyambizi C, Booysen F, Stokes A, Pavlova M, Groot W. Lifestyle and socio-economic inequalities in diabetes prevalence in South Africa: A decomposition analysis. PLoS One. 2019;14(1):e0211208. doi:10.1371/journal.pone.0211208 7. Itumalla R, Kumar R, Perera B, Elabbasy MT, Kumar Cg S, Kundur R. Patient’s Perception of Diabetes Care Services in Hail, Kingdom of Saudi Arabia. Health Psychol Res. 2022;10(3):38119. doi:10.52965/001c.38119

First, thank you very much for your professional comments on the article published in World Journal of Diabetes. Second, we read your comments with great interest. You are welcome to format your valuable comments into a Letter to the Editor and submit it online to World Journal of Diabetes at https://www.f6publishing.com. There are no restrictions on the number of words, figures (color, B/W) or authors for a Letter to the Editor. In addition, the article processing charge will be exempted for this Letter to the Editor. As with all articles published by the Baishideng Publishing Group, the Letter to the Editor will be published online after completing peer review. The guidelines for a Letter to the Editor can be found at: https://www.wjgnet.com/bpg/GerInfo/219. Finally, we look forward to receiving your high-quality Letter to the Editor, which will promote academic communication and lead the development of this discipline.