title: Complications and characteristics of patients referred to a joint diabetes renal clinic in Ireland.
abstract: METHODS
  Joint diabetes renal (JDR) clinics are recommended as the appropriate model of care to manage advanced diabetic-associated renal failure. We performed a retrospective review of clinical data and records of the first 60 patients who attended our service and their follow-up at 12 months.
  
  
  RESULTS
  Of the patients, 88 % had type 2 diabetes. At the first visit, 43 % had retinopathy, 56 % had neuropathy, 48 % had overt cardiovascular disease, 13 % had a previous history of stroke and 36 % peripheral arterial disease. Ten percent had lower limb amputation and 33 % had never previously seen a diabetologist. Fifteen percent were still on metformin despite significant renal impairment, while 43 % were on three or more different antihypertensives. Sixty-eight percent were either on an ACE inhibitor or angiotensin receptor blocker. At 12 months, a trend towards a reduction in HbA1c (7.6 ± 2.0 vs. 7.0 ± 1.6 %, p = 0.14) and systolic (159.4 ± 30.8 vs. 141.8 ± 35.5 mmHg, p = 0.13) and diastolic blood pressure (73.2 ± 9.3 vs. 69.2 ± 9.4 mmHg, p = 0.075) was observed. No significant differences were found in the lipid profile or creatinine clearance within the group.
  
  
  CONCLUSIONS
  Thirty-three percent of patients with advanced diabetic nephropathy had never previously seen a diabetes consultant and a significant proportion had other diabetes-related complications. Patients with diabetic nephropathy may therefore benefit from having a multidisciplinary input at a joint diabetes renal clinic.
authors.affiliation: Academic Department of Endocrinology, Beaumont Hospital, Dublin, Ireland. hoodthabit@physicians.ie
authors.forename: H
authors.initials: H
authors.lastname: Thabit
authors.forename: B
authors.initials: B
authors.lastname: Besharatian
authors.forename: P J
authors.initials: PJ
authors.lastname: Conlon
authors.forename: D
authors.initials: D
authors.lastname: Smith
mesh_terms: D000368:Aged; D048909:Diabetes Complications / Q000453:epidemiology* / Q000628:therapy*; D003928:Diabetic Nephropathies / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006268:Health Facilities; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D051437:Renal Insufficiency / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome