Characteristics Associated with Neuropathy and/or Retinopathy in a Hospital Outpatient Diabetic Clinic
- 67 Downloads
Background: The incidence of diabetes is increasing worldwide and with it the risk of diabetic complications. The aim of this study was to characterise parameters associated with neuropathy and/or retinopathy in a hospital outpatient diabetic clinic population.
Method: A structured questionnaire addressing diabetes related factors and demography was administered to a cross-sectional sample of patients (n = 290) with type 1 and type 2 diabetes attending a hospital diabetic outpatient clinic. Additional clinical measures were obtained from patient medical files and computerised records. Logistic regression analysis was used to identify characteristics associated with the presence of complications.
Results: When controlling for other predictors, increasing age (P < 0.01), type 1 diabetes (P = 0.05), longer duration of diabetes (P < 0.01), increased serum triglyceride levels (P = 0.03), HbA1c (>8%; P = 0.03), self-reported low physical activity levels (P = 0.05) and being a smoker (P = 0.01) were positively related to retinopathy and/or neuropathy. Patients within the study population had reasonably well controlled BP and serum lipids, thus explaining the absence of these particular variables from the list of predictor parameters. Other factors including diabetes knowledge, home blood glucose monitoring, gender, body mass index, clinic attendance and occupational status were not significantly associated with retinopathy or neuropathy in the present study population.
Conclusions: Pharmacists and other health practitioners who are in a position to be involved in the care and management of patients with diabetes should raise awareness of complications, particularly amongst patients who present with the above risk factors and provide necessary counselling and advice as required.
KeywordsCounselling Diabetes Microvascular complications Neuropathy Northern Ireland Retinopathy Risk factors
Unable to display preview. Download preview PDF.
- 5.Wändell, PE. 1997Risk factors for microvascular and macrovascular complications in men and women with type 2 diabetesScand J Primary Health Care1711621Google Scholar
- 8.Chaturvedi, N, Stephenson, JM, Fuller, JH. 1999The relationship between socio- economic status and diabetes control and complications in the EURODIAB IDDM Complications StudyDiabetes Care1942330Google Scholar
- 15.OPCS Standard Occupational Classification Volume 3. London: HMSO, 1991Google Scholar
- 16.Fitzgerald, JT, et al. 1998The reliability and validity of a brief diabetes knowledge testDiabetes Care1070610Google Scholar
- 19.Zhang, PL, Krzentowski, G, Albbert, A. 2000Development and progression of retinopathy in DCCT type 1 diabetic patients with good or poor metabolic controlDiabetes49A173Google Scholar
- 20.UK Prospective Diabetes Study Group 38.1998Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetesBMJ3177160703–13 [published erratum appears in BMJ 1999; 318: 29]Google Scholar
- 21.The Diabetes Control and Complications Trial Research Group.1993The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulindependent diabetes mellitusNEJM32997786Google Scholar
- 22.Peters, AL. 2000The clinical implications of insulin resistance (Review)Am J Manage Care6S66874discussion S675–81, 21Google Scholar
- 25.Needy, RA, et al. 1998The epidemiology of diabetes mellitus and diabetic retinopathyIntern Ophthalmol Clin38118Google Scholar