title: Ophthalmic health care in diabetes mellitus: a cross-sectional study in northern Sweden.
abstract: The purpose of this study was to estimate the prevalence of diabetic retinopathy, visual impairment/blindness and previous surgical eye treatments in patients with older-onset vs. younger-onset diabetes mellitus. A cross-sectional study of patients with diabetes mellitus in the area of Umeâ, Sweden (135,000 inhabitants) was performed during 1994-1995, comprising 1,805 diabetic patients. Diabetic patients of younger ages were referred more frequently than older for fundus examination. With age at diagnosis <30 years retinopathy was seen in 68% of the patients; with age at diagnosis 30 years or older retinopathy was seen in 66% of the insulin-treated, 30% of the oral agent-treated and 7% of the diet-treated patients. Retinopathy that had previously been treated or needed treatment was seen in about one-third of the patients in both the younger-onset and the insulin-treated older-onset groups. The corresponding values for the oral agent-treated and diet-treated older-onset diabetic patients were 9.4% and 0.6%, respectively. No older-onset diabetic patient with acceptable glycemic control and with only dietary treatment had received or needed ophthalmic treatment. In the Umeâ area, patients with a relatively short duration of diabetes had a lower prevalence of diabetic retinopathy than that found in Wisconsin in 1979-1980. We conclude that demand for ophthalmic care in general is much higher for older-onset diabetic patients because of the greater number of patients with older-onset than younger-onset diabetes. In addition, older-onset patients should be examined regularly for treatable retinopathy. Diet-treated older-onset diabetic patients with acceptable glycemic control need little ophthalmic screening.
authors.affiliation: Umeå University, Department of Ophthalmology, Umeå, Sweden.
authors.forename: C O
authors.initials: CO
authors.lastname: Reuterving
authors.forename: J
authors.initials: J
authors.lastname: Kratholm
authors.forename: L
authors.initials: L
authors.lastname: Wachtmeister
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D002648:Child; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000628:therapy; D003930:Diabetic Retinopathy / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome