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M. Dirani, E. Fenwick, A. K. McAuley, M. Larizza, G. Rees, T. Y. Wong, E. L. Lamoureux; Recruitment and Testing Protocol of the Diabetes Management Project (DMP) - Identifying Barriers to Optimal Care in People With Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2089.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the testing and recruitment modalities of the first Australian Diabetes Management Project (DMP), investigating the barriers to optimal diabetes care in adults with type I and II diabetes mellitus (DM), with and without diabetic retinopathy (DR) .
Individuals with type I and II diabetes, with and without DR, aged 18 years or older, English-speaking and no significant cognitive impairment were invited to participate in the DMP. Most study participants were recruited through ophthalmology clinics at the Royal Victorian Eye and Ear Hospital (Melbourne). Each participant underwent several assessments which included personal and socioeconomic information, anthropometric measurements, 8 behavioural and psycho-social questionnaires and blood and urine samples were collected for biochemical analyses. Ophthalmic tests included presenting LogMAR visual acuity, dilated auto-refraction, ocular biometric measurements, optical coherence tomography and fundus photography. Good diabetes control was defined as HbA1c < 7% and blood pressure [BP] ≤130/80mmHg, respectively.
Of the 4468 patients screened, 690 (15.4%) were eligible, with 423 (61.3%) accepting the invitation into the DMP. Assessments sessions, ranging between 3-4 hours, occur between 8 to noon to take accommodate our fasting patients. To date, 200 participants [136 males (68.0%)] aged between 27 and 90 years (mean age = 64.2 years) have been examined. The mean HbA1c for all participants was 7.68% (range = 5.0% to 12.8%), with mean arterial BP (MABP) being 97.9mmhg. Almost half (n = 87, 46.6%) of our patients had poor diabetes control, with no age or gender effects (p>0.05).
One-fifth of the expected DMP cohort has been examined, with a high positive response rate. The DMP has demonstrated the successful implementation of a comprehensive protocol to investigate the barriers associated with sub-optimal diabetes care in individuals with and without DR. Almost half of our recruited patients had poor diabetes care, which further substantiates the rationale for undertaking the DMP.
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