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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. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
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 2. Survey Results
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