Screening for people with diabetes mellitus for poor blood glucose control in an ophthalmological laser clinic.
OBJECTIVE
The study was performed to test the effect of a structured intervention in diabetic patients with poor glycaemic control in an ophthalmological department.


METHODS
All the patients attending the ophthalmological out-patient department with the need for laser therapy due to diabetic retinopathy were investigated from January to March 1998 (Type 1: n=20, Type 2: n=144). If an HbA(1c)-level higher than 9.0% was found the patient was informed within 1 week and a standardised letter was sent to the primary care physician and the local ophthalmologist. Over the first 3 months of 1999 the effect was evaluated.


RESULTS
HbA(1c) values higher than 9.0% were found in eight/20 of the patients (40%) with Type 1 diabetes and in 61/144 of the patients (54%) with Type 2 diabetes. In 55% this new information in the context of the need for laser therapy resulted in the acceptance of a structured intervention by the patient. This led to an improvement of the HbA(1c) in the people with Type 1 diabetes.


CONCLUSIONS
Patients with poor blood glucose control can be identified in an ophthalmological department. The need for laser therapy can be used to motivate the patients for a significant improvement of the quality of blood glucose control.
Schiel
R
R
Department of Internal Medicine II, University of Jena Medical School, D-07740 Jena, Germany. ralf.schiel@med.uni-jena.de
Blum
M
M
Müller
U A
UA
Köhler
S
S
Kademann
A
A
Strobel
J
J
Höffken
K
K
D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D001794:Blood Pressure; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D005858:Germany; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009887:Ophthalmoscopy; D010044:Outpatient Clinics, Hospital
D001786:Blood Glucose; D006442:Glycated Hemoglobin