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S. Albin, J. Benevento, J. Chang, R. D. Jager; Diabetic Retinopathy Knowledge in University Clinic Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):171.
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To determine the extent of knowledge of diabetic patients in a university ophthalmology clinic regarding diabetic retinopathy (DR), its treatment, and the effect of systemic comorbidities on DR.
A prospective study of diabetic patients from the University of Chicago Hospitals was performed. Patients completed a detailed eighteen question survey addressing their knowledge of diabetes, blood glucose levels, hemoglobin A1c, and DR.
Of 20 diabetic patients surveyed, only 65% correctly classified their diabetes as Type 1 or Type 2. 90% of patients could identify normal blood glucose levels, and 20% recorded ever having had blood sugar levels above 300 mg/dL. Only 50% of patients knew about hemoglobin A1c (HbA1c), and only 40% of patients correctly identified an appropriate target HbA1c level. Patients who knew about HbA1c had a higher average maximum blood sugar level (244 +/- 88 vs. 195 +/- 37 mg/dL) and were three times more likely to report ever having a blood sugar level above 300 mg/dL. Seven patients received laser treatment for DR, and 50% of patients correctly answered that the laser treatment was performed to prevent their vision from worsening, while 33% believed it was performed to prevent diabetes from affecting their eyes, and 17% did not know why they underwent laser treatment. Although the majority (75%) of patients correctly answered that tight blood sugar control decreased the risk of DR, they also reported higher average maximum blood sugar levels than those who answered incorrectly (225 +/- 77 vs. 203 +/- 49 mg/dL) and were three times more likely to report ever having a blood sugar level above 300 mg/dL. With regard to systemic comorbidities, 70% of patients correctly answered that high blood pressure worsened DR, 50% correctly answered that high cholesterol worsened DR, and only 35% of patients correctly answered that aspirin had no effect on DR.
The level of disease awareness of diabetic patients in a university clinic is poor, and there is a significant need for greater patient education on monitoring diabetes and recognizing confounding factors of diabetic retinopathy. Poor insight into the disease was associated with lower reported blood glucose levels.
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