ABSTRACT
BACKGROUND: The prevalence of type 2 diabetes is increasing, but the exact prevalence of the disease and its accompanying late complications are unknown. In the Anglo-Danish-Dutch study of Intensive Treatment in People with Screen-detected Diabetes in Primary Care (ADDITION study), patients with hitherto undiagnosed type 2 diabetes are identified using a stepwise screening strategy in selected general practices. This article reports the occurrence of diabetic retinopathy in this population. METHODS: In Arhus and Copenhagen counties, a total of 12,708 of the persons invited by mail were screened for diabetes mellitus. Consequently, 763 persons with type 2 diabetes were identified; 670 of these (335 from each of the two centres) underwent a general physical examination (including measurement of blood pressure and HbA1c) and an ophthalmological examination (including measurement of visual acuity and fundus photography). Retinopathy was graded from the photographs by counting all retinopathy lesions. RESULTS: Forty-five (6.8%) of the examined patients had any retinopathy, of which the majority was minimal. No patients had severe non-proliferative or proliferative diabetic retinopathy. There was no significant difference between age, sex and visual acuity among patients with and without retinopathy. However, the patients with retinopathy had significantly higher HbA1c and systolic and diastolic blood pressure than the patients without retinopathy. CONCLUSION: Patients with screen-detected diabetes have a low prevalence of diabetic retinopathy and no vision-threatening lesions. Screening for diabetic retinopathy should be focused on those patients who have already been diagnosed with type 2 diabetes during routine clinical practice.
Subject(s)
Diabetes Mellitus, Type 2 , Diabetic Retinopathy/epidemiology , Blood Pressure , Denmark/epidemiology , Diabetic Retinopathy/physiopathology , Diastole , Female , Glycated Hemoglobin/metabolism , Humans , Male , Middle Aged , Prevalence , Systole , Visual AcuityABSTRACT
PURPOSE: To investigate the current status of screening for diabetic retinopathy in Denmark, focussing on organization, methods of screening and regional differences. METHODS: A questionnaire was sent out in 2002 to 14 departments of ophthalmology and one ophthalmology practice, covering all 15 counties in Denmark. RESULTS: Six counties reported having systematic screening, defined as organized screening, including a database; three reported having plans for systematic screening; two reported having undetermined plans for systematic screening and four reported having no plans for systematic screening. In counties with systematic screening, both the organization and the method of screening varied. CONCLUSION: Approximately 43% of Danish patients with diabetes currently live in a county without systematic screening for diabetic retinopathy. Should all counties contemplating systematic screening implement their plans, this proportion will be reduced to approximately 17%.