July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Baseline characteristics of diabetic patients presenting to a retina clinic
Author Affiliations & Notes
  • Nish Patel
    University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Lilia Verchinina
    The Brehm Center, University of Michigan, Ann Arbor, Michigan, United States
  • Patrick Hughes
    Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, United States
  • Michele Wichorek
    The Brehm Center, University of Michigan, Ann Arbor, Michigan, United States
  • Thomas W. Gardner
    Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
  • Dorene Markel
    The Brehm Center, University of Michigan, Ann Arbor, Michigan, United States
    Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Anjali Shah
    Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
  • Footnotes
    Commercial Relationships   Nish Patel, None; Lilia Verchinina, None; Patrick Hughes, None; Michele Wichorek, None; Thomas Gardner, Novo Nordisk (C); Dorene Markel, None; Anjali Shah, None
  • Footnotes
    Support  Research to Prevent Blindness, Taubman Institute
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1904. doi:
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      Nish Patel, Lilia Verchinina, Patrick Hughes, Michele Wichorek, Thomas W. Gardner, Dorene Markel, Anjali Shah; Baseline characteristics of diabetic patients presenting to a retina clinic. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1904.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Effective glycemic control and blood pressure management have been shown to decrease both the incidence and progression of diabetic retinopathy (DR). Despite this correlation, ophthalmologists are often unaware of patients’ overall diabetes management. We propose that obtaining comprehensive data on diabetic patients will allow ophthalmologists to better risk stratify and tailor patient care. We implemented a program to collect data on diabetic patients presenting to the Kellogg Eye Center retina clinic and retrospectively reviewed the data to report baseline characteristics.

Methods : Demographics, body-mass index (BMI), blood pressure (BP), hemoglobin A1c (A1c), smoking history, diabetes type, diagnosis, diabetes duration, and kidney disease history based on both self-report and microalbuminuria were collected on all diabetic patients from 7/1/16 to 6/30/17. A subgroup of patients with 2 or more of the following factors was targeted for additional data collection and analysis: A1c>9% in the last 6 months, BP>140/90 mmHg in the last 6 months, history of kidney disease, diabetes duration>10 years. Subgroup patients were administered a multiple choice survey to assess knowledge of diabetic management goals.

Results : 2378 patients with 5578 visits were represented in the cohort studied; 826 patients were in the subgroup. Baseline characteristics of the cohort and subgroup are reported in Table 1. 418 subgroup patients completed the diabetes management survey; the distribution of patient answers is shown in Table 2. Demographics of the cohort are as expected. Interestingly, only 57.57% of diabetic patients seeking retina care have DR, and only 17.16% report kidney disease.

Conclusions : Implementation of this program allowed the creation of a longitudinal dataset on diabetic patients presenting to a retina clinic. Despite low mean A1c and number of visits, the large range of A1c values (4.3%-15.2%) and number of visits over 1 year (1 to 19) suggest that significant healthcare resources are being devoted to a small number of patients. Finally, 87.56% of diabetic patients surveyed from the subgroup know their A1c goal, suggesting that knowledge of care goals is not a primary cause of poor control. Further data collection and analysis will lead to better understanding of which diabetic patients are most at risk for vision loss, and how to best address their needs.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Table 1. Baseline Characteristics

Table 1. Baseline Characteristics

 

Table 2. Survey Results

Table 2. Survey Results

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