title: Short report: suboptimal diabetes care in high-risk diabetic patients attending a specialist retina clinic.
abstract: OBJECTIVE
  Individuals with diabetic retinopathy (DR) represent a high-risk group who would benefit from intensive metabolic control and risk factor management. This brief report examines quality of care among diabetic patients attending a tertiary retinal clinic.
  
  
  METHODS
  A cross-sectional survey, notes review, and slit-lamp examination was conducted in 139 diabetic patients attending a specialist retinal clinic to assess the quality of comprehensive diabetes care. DR was graded according to the Early Treatment Diabetic Retinopathy Study scale.
  
  
  RESULTS
  The prevalence of non-proliferative DR (NPDR) and proliferative DR (PDR) was 39.6 and 35.2%, respectively. The prevalence of microalbuminuria in patients with no DR, NPDR and PDR was 32, 54.1 and 68.8%, respectively. Glycaemic control was suboptimal (mean HbA(1c) 8.0 +/- 1.8%) and 15.8% were current smokers. Drugs affecting the renin-angiotensin system were used by only 61.9% of patients with both DR and microalbuminuria, and aspirin by only 35.3%.
  
  
  CONCLUSIONS
  These data suggest that diabetes care in this high-risk population with established microvascular complications was suboptimal. Specialist clinics dealing with diabetic complications may be a setting where quality improvement strategies to reduce morbidity and mortality should be focused.
authors.affiliation: Division of Endocrinology and Metabolism, University of Alberta, Edmonton, AB, Canada.
authors.forename: S A
authors.initials: SA
authors.lastname: Al-Ansari
authors.forename: M T S
authors.initials: MT
authors.lastname: Tennant
authors.forename: M D J
authors.initials: MD
authors.lastname: Greve
authors.forename: B J
authors.initials: BJ
authors.lastname: Hinz
authors.forename: P A
authors.initials: PA
authors.lastname: Senior
authors.forename: C P
authors.initials: CP
authors.lastname: Hanson
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000628:therapy*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D015995:Prevalence
chemical_list: D006442:Glycated Hemoglobin