ABSTRACT
AIMS: No information exists on the frequency of visual impairment in people with diabetes mellitus (DM) in Germany. In this study, the prevalence of vision impairment in those individuals was investigated. METHODS: We retrospectively analyzed a cohort of 295 people (14221 consultations) at a university outpatient clinic with any type of DM and an available ETDRS-Score and visual acuity. The primary outcome was the prevalence of visual impairment, the secondary outcome was the correlation of the ETDRS-Score and limitations of visual acuity and the prevalence of higher ETDRS-Score with a visual impairment defined as a decimal-visus=0.3. RESULTS: The prevalence of visual impairment in participants with DM was 11.2%; among these individuals, 81.8% had no or non-proliferative retinopathy. In the DM2 subgroup, 81.5% (n=22) of the visually impaired participants had no DR, in contrast to only 16.7% (n=1) in the DM1 subgroup. Progression in ETDRS-Score led to worse visual acuity (r=-0.209; p<0.001). A significantly related covariates with impairment of the visual acuity for individuals with DM1 was the duration of diabetes (B=-0.007; p=0.001) and for individuals with DM2, the age (B=-0.008; p=0.009). CONCLUSIONS: The prevalence of impaired vision in people with diabetes in our cohort was 11.2%,<20% of visual impairment in people with diabetes is caused by diabetic retinopathy, and 69.7% of participants with visual impairment had no DR. In our study patients without visual impairment showed a similar distribution of DR severity levels regardless of the type of diabetes.
Subject(s)
Diabetes Mellitus, Type 2 , Diabetic Retinopathy , Humans , Prevalence , Retrospective Studies , Diabetic Retinopathy/epidemiology , Diabetic Retinopathy/complications , Visual Acuity , Vision Disorders/epidemiology , Vision Disorders/etiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiologySubject(s)
Encephalitis, Viral/complications , Herpesvirus 6, Human/isolation & purification , Leukemia, Myeloid, Acute/complications , Acyclovir/therapeutic use , Adult , Antimetabolites, Antineoplastic/therapeutic use , Antiviral Agents/therapeutic use , Cytarabine/therapeutic use , Encephalitis, Viral/drug therapy , Encephalitis, Viral/pathology , Female , Herpesvirus 6, Human/drug effects , Humans , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/pathologyABSTRACT
OBJECTIVE: The quality report of the disease management programmes of North Rhine Westphalia 2016 showed prevalences for long-term complications (neuropathy, nephropathy, retinopathy) of less than 30% for people with diabetes type 1 (DM1) and type 2 (DM2). The aim of this study was to assess risk expectations and fear regarding long-term complications of diabetes in people with DM1 and DM2. METHODS: We assessed risk expectations and fear regarding diabetes complications in people with DM1 (n=110) and DM2 (n=143 without insulin, n=249 with insulin) visiting an University outpatient department of metabolic diseases. Fear of long-term complications was measured with the "Fear of Complications Questionnaire (FCQ)" (range 0-45 points, scores ≥30 suggest elevated fear). Participants were asked to estimate general and personal risks of long-term complications 10 years after developing diabetes in %. RESULTS: Elevated fear of complications (FCQ scores ≥30) was observed in 34.5, 25.9, and 43.0% of those with DM1, DM2 without insulin and DM2 with insulin, respectively. Participants estimated a mean general risk of diabetes-related complications after 10 years amounting to 45.9±15.8% (DM1), 49.7±15.4% (DM2 without insulin), and 52.5±16.4% (DM2 with insulin) and personal risk with 52.5±24.4% (DM1), 45.8±22.7% (DM2 without insulin), and 54.1±23.4% (DM2 with insulin), respectively. Higher risk expectations were associated with higher fear of complications (p<0.001). CONCLUSION: Risk estimations regarding long-term complications were exaggerated in people with DM1 and DM2. About one third of the participants reported elevated fear of complications. Participants' risk expectations and fear regarding diabetes complications appear excessive compared to population-based prevalence rates.
Subject(s)
Diabetes Complications/psychology , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 2/psychology , Fear/psychology , Surveys and Questionnaires , Adult , Aged , Diabetes Complications/epidemiology , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Female , Humans , Male , Middle Aged , PrevalenceABSTRACT
AIMS: We examined prevalence and progression of retinopathy in dependence on diabetes duration in order to estimate the probability of progression. PATIENTS/METHODS: In a retrospective cohort-analysis from an academic outpatient department of endocrinology and metabolic diseases we analyzed 17461 consultations of 4513 patients with DM2 from 1987 to 2014. 50.3% of the patients (n=2272) had at least one documented result of funduscopy. RESULTS: 25.8% of the patients had retinopathy (20.2% non-proliferative, 4.7% proliferative, 0.7% were not classified, 0.1% blindness). The prevalence of retinopathy in dependence on diabetes duration was 1.1% at diagnosis, 6.6% after 0<5 years, 12% after 5<10 years, 24% after 10<15 years, 39.9% after 15<20 years, 52.7% after 20<25 years, 58.7% after 25<30 years and 63% after ≥30 years. In a subset of 586 (25.7%) patients with retinal photography of 3 consecutive years 7.0% showed deterioration after one and 12.2% after two years; 2.6% improved after one and 2.8% after two years. 201 (34.3%) of this group had<10 years diabetes and lower deterioration (4.5% worsened after one and 9.5% after two years). Their retinopathy mainly transformed from no retinopathy to non-proliferative. Four patients (2.0%) developed proliferative retinopathy. CONCLUSIONS/INTERPRETATIONS: Within the first 10 years of diabetes duration, the prevalence of retinopathy is low and the progression infrequent. Most patients have a non-proliferative form which can be reversible and rarely requires interventions. Patients with DM2 without retinopathy and good glycaemic control do not run into additional risk from expanding funduscopy intervals to biennial.