Vergleich der Risikoparameter der diabetischen Retinopathie und der leitliniengerechten Prävention für Patienten einer diabetischen Schwerpunktambulanz und eines Lasertherapiezentrums

Abstract

The purpose of this study was the comparison of risk factors for development or progression of diabetic retinopathy in patients with type 2 diabetes between patients of a laser therapy center and a diabetes outpatient clinic. Furthermore, the implementation of the guidelines of the German Diabetic Association for the prevention and therapy of diabetic retinopathy was analysed. In a prospective study, patients with type 2 diabetes and diabetic retinopathy of the laser therapy center at the ophthalmology department, Leipzig University, were interviewed and examined. Patients of the reference group without diabetic retinopathy were recruited from the diabetes outpatient clinic Leipzig University. Between August 2004 and May 2008, a total of 180 patients with type 2 diabetes were included (48 patients with non-proliferative diabetic retinopathy (NPDR), 59 patients with proliferative diabetic retinopathy (PDR) and 73 patients belonging to the reference group). Patients with diabetic retinopathy had significantly higher mean blood pressures of 112 and 110 mmHg as compared to patients without diabetic retinopathy (96 mmHg). ACE/ AT1-inhibitors were used significantly less by patients with as compared to patients without diabetic retinopathy. Only 37% of patients with diabetic retinopathy were treated according to DDG and ADA guidelines. There are striking deficits for the implementation of guideline oriented prevention and therapy of diabetic retinopathy in daily practice. The possible reasons are insufficient compliance of patients who consulted medical advice only when complications of diabetes occurred, the necessary improvement of the medical therapy and the suboptimal cooperation between ophthalmology and diabetes specialists.