Influence of drop–out from medical follow–up on visual acuity prognosis in early–onset type 2 diabetes mellitus

Abstract

Abstract: : Purpose:The influence of drop–out from medical follow–up on visual acuity prognosis in patients with early–onset type 2 diabetes mellitus was assessed retrospectively. Methods:We reviewed the medical records of 95 patients who had been diagnosed before age 30 as having type 2 diabetes and 47 duration of diabetes–matched patients with type 1 diabetes. The follow–up duration was five years or more. "Drop–out" was defined as failure to return to the clinic for more than 4 times the period recommended by the ophthalmologist. Results:There was no significant difference between the type 2 and type 1 diabetes mellitus patients in mean HbA1c values, mean visual acuity, or distribution of the degree of diabetic retinopathy at first visit. There was no blindness in either group at first visit. Whereas 21 of the type 2 diabetes mellitus patients (22.5%) dropped out of ophthalmological follow–up, only 4 of the type 1 diabetes mellitus (0.09%) patients dropped out (p=0.034). Final visual acuity was significantly worse in type 2 diabetes mellitus patients (p=0.018), with 8 of type 2 (0.08%) but none of the type 1 diabetics becoming blind during the follow–up period. Among patients without who did not drop out, there was no significant difference between the type 1 and 2 diabetics in visual acuity. Conclusions:Among the young, type 2 diabetes mellitus patients have a poorer visual acuity prognosis than those with type 1 diabetes mellitus. One of the reasons for this poor prognosis is that type 2 diabetes mellitus patients often failure to return for ophthalmological follow–up.

Keywords: diabetes • diabetic retinopathy