Abstract
BackgroundRegular examination and early treatment of diabetic retinopathy can prevent visual loss. The aim of the study was to describe the care of vision and ocular health in people with diabetes in Norway.MethodsA cross-sectional questionnaire survey of a random sample (n = 1,887) of the Norwegian Diabetic Associations' (NDA) members was carried out in 2005. Questions were asked about care of vision and ocular health, history of ocular disease and visual symptoms, general medical history and diabetes management. The study was approved by the Regional Committee for Medical Research Ethics.ResultsThe response rate was 74%. Forty-four questionnaires with incomplete data regarding gender, age or type of diabetes were excluded, leaving 1352 cases (52% females) for analysis. 451 (33%) had type 1 and 901 (67%) had type 2 diabetes, the mean duration of diabetes was respectively, 22 (sd ± 14) and 10 (sd ± 9) years. In all 1,052 (78%) had their eyes examined according to guidelines and 1,169 (87%) confirmed to have received information about regular eye examinations. One in two recalled to have received such information from their general practitioner. To have received information about the importance of eye examinations (PR 3.1, 95% CI 2.4 to 4.0), and diabetes duration > 10 years (PR 1.2, 95% CI 1.2 to 1.3), were independently associated with reporting regular eye examinations. A history of diabetic retinopathy was reported by 178 (13%) responders, of which 101 (57%) reported a history of laser treatment. Responders who had regular eye examinations reported more frequently a history of diabetic retinopathy (19% vs. 5%, p < 0.001). The frequency of retinopathy was significantly higher in responders with reported HbA1c values above treatment target (23% vs. 13%, p = 0.001). However, in responders who were not regularly examined, there was no difference in reported frequency of retinopathy with regard to HbA1c level.ConclusionEight out of ten diabetic members of the NDA had their eyes examined according to current guidelines and the majority was well informed about the risk of vision loss due to diabetes. The results indicate that the reported history of diabetic retinopathy likely underestimates the prevalence of retinopathy.
Highlights
Regular examination and early treatment of diabetic retinopathy can prevent visual loss
The prevalence of diabetic retinopathy in Norway is sparsely described in the literature [4,5]
The vast majority of persons with diabetes responding to this survey had their eyes examined according to guidelines advised by the Norwegian College of General Practitioners [26], Table 1
Summary
Regular examination and early treatment of diabetic retinopathy can prevent visual loss. Most diabetic patients will develop some degree of retinopathy. In Western Europe, diabetic retinopathy accounts for 4.7–13.3% of the blind and partial sight registrations [3,15,16,17]. Regular examination of ocular health and early treatment of diabetic retinopathy can prevent most cases of visual loss [18,19,20,21,22], and ophthalmologic screening of patients with diabetes is more cost-effective than many other health interventions for detecting and treating disease [21,23]. The Norwegian College of General Practitioners has published guidelines for examination of ocular health in patients with diabetes, first issued in 1988 [24]. In 1996 only 53% of diabetic patients seen in general practice were managed according to these guidelines [25,26]
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