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Yanhong Zou, Qian Li, Ning Zhang, Wei Jia, Xipu Liu; Epidemiological study of diabetic retinopathy in community diabetic care program in Beijing urban area. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1545.
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To investigate the prevalence and risk factors of diabetic retinopathy (DR) in type 2 diabetes patients in community diabetic care program in Beijing urban area.
Four community health clinics were selected randomly from Desheng Community Health Center in Beijing. Based on the health records, type 2 diabetes patients, who have participated in community diabetic care program and visited the community health clinics regularly during the past half year, were enrolled into this study. Appointments of eye examination were made through telephone calls. An investigation group including three eye physicians or nurses conducted the survey in the local health clinics. Patient demographics and medical history were collected. Two-field 45 degree color fundus images were taken through an undilated pupil. Visual acuity and anterior segment of the eyes were also checked. A questionnaire survey about community care was conducted face to face. The retina was graded using Scottish Diabetic Retinopathy Grading System 2003. Data collection was secured with the EpiData and statistical analysis was performed using the R software.
A total of 720 patients were enrolled in the study from November 2011 to May 2012. Among them, 519 (72.1%) participated in the survey. The mean age of the patients was 69.3 years (60.4-78.2), the mean duration of diabetes was 11.2 years (2.8-19.6), and the mean level of random blood glucose was 9.4 mmol/L (5.9-12.9). Good quality photos were taken in 85.8% (445/519) of the right eye and 88.1% of the left eye. Among all the eyes with qualified photos, there were 76.2% without any DR, 16.6% with mild nonproliferative DR (R1), and 7.2% with referable DR. Only 477 patients (91.9%) with qualified retina photos in at least one eye were included in the logistic regression analysis. Logistic regression revealed that the duration of diabetes and the level of systemic blood pressure were positively associated with the present of diabetic retinopathy. No significant relation was found between DR and community interventions.
Duration of diabetes is one of the main risk factors of diabetic retinopathy in this study which suggests that close observation is required for patients with long duration. Optimal control of blood pressure is also important for reducing retinopathy in community diabetic care.
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