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

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.