Poor metabolic and blood pressure control in patients with diabetic retinopathy attending a tertiary ophthalmic hospital in Australia.
OBJECTIVE
To determine the adherence to recommended glycemic and blood pressure levels in patients with diabetic retinopathy (DR).


METHODS
A retrospective study in a tertiary eye clinic in Melbourne, Australia. Data pertaining to blood pressure (BP) and glycosylated hemoglobin (HbA1c) level were extracted from charts over a 3-month period. Optimal HbA1c was defined as levels <7%, and optimal BP control was defined as systolic/diastolic <130/80mmHg.


RESULTS
Of the 483 patients with DR in this study, only 54% (259/482) had a recorded HbA1c measurement. Of these, only 14% (36/259) had an optimal HbA1c level. Patients with longer diabetes duration were less likely to attain optimal HbA1c levels (age and gender adjusted odds ratio (OR) 0.23; 95% confidence intervals (CIs) 0.08-0.71 for diabetes duration 11-19 years, and OR 0.18%, 95% CI 0.06-0.58 for duration >20 years versus </=5 years). Optimal BP control was attained in only 18% (86/483) and was associated with younger age (OR 0.98; 95% CI 0.96-0.99, per year increase in age).


CONCLUSIONS
Adherence to clinical guidelines for glycemic and BP control in patients with DR was low, even in a well-developed healthcare system with free ophthalmic care access.
Tikellis
Gabriella
G
Centre for Eye Research Australia, University of Melbourne, Australia.
Wang
Shiqi
S
Wong
Nathan
N
Wang
Jie Jin
JJ
Alex Harper
C
C
Wong
Tien Y
TY
D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009885:Ophthalmology; D018579:Patient Selection; D014739:Victoria
D006442:Glycated Hemoglobin