Abstract
Purpose :
Volunteers in Medicine (VIM) Clinic is a free primary care clinic that serves low-income patients in Lane County, Oregon. VIM patients with diabetes are referred to an ophthalmologist for yearly eye exams and a dietician for nutrition education. These resources are important because increased blood glucose levels over long periods of time can lead to diabetic retinopathy (DR). We aimed to evaluate the utilization of dietician visits (telehealth or in-person) and the presence of DR at VIM.
Methods :
We conducted a retrospective chart review of diabetic patients who had received eye exams through VIM since 2019. We assessed ophthalmic exam findings, visual acuity, A1C taken within 3 months of the eye exam, and frequency and type of dietetic visit (0, 1-2, or greater than 3) in the year prior to the eye exam. Patients could attend their dietician visits in person or through telehealth.
Results :
77 patients (46 female, 31 male; mean age 52.6±10.8) were identified. A total of 159 eye exams were completed, averaging 1.9 visits per patient. 22 patients did not attend any dietician appointments, 24 attended 1-2 visits, and 31 attended 3 visits or more. Patients who did not attend any dietician visits had an average A1C of 8.04% (±2.20%), those who attended 1-2 had an average of 7.78% (±1.74%) and those who attended 3 or more had an average A1c of 9.16% (±1.99%). 58 patients did not have evidence of DR, and 19 patients were found to have some evidence of DR. A chi-squared test comparing the absence or presence of diabetic retinopathy in patients with no dietician visits, 1-2 visits, or greater than 3 visits revealed an insignificant relationship between the variables X2 (2, N = 77) = 2.28, p > .05. A linear regression model revealed that the percentage of telehealth visits attended (B=1.2 p>0.05) and number of dietician visits (B=0.9 p>0.05) were not significantly associated with presence or absence of DR.
Conclusions :
VIM has developed a successful referral program for patients to monitor their diabetic symptoms and encourage positive lifestyle changes to minimize the risk of developing DR. Patients with higher A1c values are encouraged to attend more dietician appointments to manage their diabetic care. The lack of a significant relationship between the ratio of telehealth to in-person visits and presence of DR suggests that telehealth visits may be suitable for managing diabetes effectively.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.