Abstract
Abstract Disclosure: A. Sami: None. S. Gurnurkar: None. N. Vyas: None. Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus (DM) and a major cause of vision loss. Risk factors for development of DR include duration of diabetes and poor glycemic control. Adolescents with diabetes face unique challenges in attaining glycemic control due to hormonal changes and transition from pediatric to adult care. The aim of this study was to determine the adherence to ADA DR screening guidelines in an ambulatory Endocrine clinic’s adolescent patient population, and to determine factors associated with non-adherence. Methods: A retrospective chart review was conducted on patients (ages 12-18) with type 1 diabetes (T1D) and type 2 diabetes (T2D) at Nemours Children’s Hospital between 2015 and 2022, with 142 charts included. Based on the ADA DR screening guidelines, patients with T1D were included if they had diabetes for at least 5 years and all patients with T2D between the ages of 12-18 were included. Patients were considered adherent if they met one of the following criteria: Recorded eye exam within the past 1 year (for T2D) or the past 2 years (for T1D) documented in chart OR attendance to an appointment with Nemours ophthalmology within a year of referral. Age, sex, ethnicity, race, insurance type, and HbA1c were recorded. Univariate binomial logistic regression analysis was completed to determine the association of the factors to DR guideline adherence. Results: Data analysis showed 69% adherence and 31% non-adherence to DR screening guidelines. The non-adherence rate was comparable to other studies in adult and youth populations. Patients with T2D were 58.3% less adherent to DR screening guidelines compared to patients with T1D (OR= 0.417, 95% CI 0.178-0.978). We did not find statistical significance with other factors. The results highlight adolescent patients with T2D as a target population for future studies aimed at improving adherence to DR screening guidelines. Presentation: Friday, June 16, 2023
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