Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
Can J Ophthalmol ; 52 Suppl 1: S19-S29, 2017 Nov.
Article in English | MEDLINE | ID: mdl-29074008

ABSTRACT

OBJECTIVE: The Screening for Limb, I-Eye, Cardiovascular, and Kidney Complications (SLICK) Program was implemented in 1999 to improve diabetic care for Alberta First Nations individuals living on reserve. The purpose of this review is to determine the rate and predictors of progression of diabetic retinopathy (DR) over a 10-year period. DESIGN: Cohort study. PARTICIPANTS: Nine hundred and eighty First Nations patients with diabetes that underwent at least 2 teleophthalmology examinations during the study period. METHODS: Patients underwent serial laboratory testing, and stereoscopic, mydriatic, retinal photography. Modified Early Treatment Diabetic Retinopathy Study grading of retinal images was performed via teleophthalmology. Progression was defined as an increase of 2 or more steps on the Diabetes Control and Complications Trial classification. RESULTS: At baseline, most patients had no diabetic retinopathy (n = 777, 79.3%) whereas 203 people (20.7%) had either nonproliferative DR (n = 179, 18.3%) or proliferative DR (n = 24, 2.5%). Two-step progression occurred in 163 patients (16.6%), with only a minority of these individuals progressing to proliferative DR (n = 23). The median time to progression was 7.6 years. Multivariate Cox regression demonstrated that elevated hemoglobin A1C (hazard ratio [HR] = 1.42; p < 0.0001) and systolic blood pressure (HR = 1.24 per 10 mm Hg; p = 0.009) were independent predictors of progression of DR. CONCLUSIONS: This population-based study has shown that the rate and predictors of progression of DR among First Nations individuals parallels non-First Nations populations, with HbA1C and systolic blood pressure being the strongest predictors. These findings suggest that targeted, individualized care to reduce blood pressure and control blood sugars could reduce progression of diabetic retinopathy, and possibly blindness in First Nations individuals living on reserve.


Subject(s)
Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/ethnology , Indians, North American/ethnology , Alberta/epidemiology , Blood Glucose/metabolism , Blood Pressure , Cohort Studies , Diabetic Retinopathy/blood , Disease Progression , Female , Glycated Hemoglobin/metabolism , Humans , Male , Middle Aged , Risk Factors , Telemedicine/methods
2.
Can J Ophthalmol ; 47(4): 365-75, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22883847

ABSTRACT

OBJECTIVE: The Screening for Limb, I-Eye, Cardiovascular, and Kidney Complications (SLICK) Program was implemented in 1999 to improve diabetic care for Alberta First Nations individuals living on reserve. The purpose of this review is to determine the rate and predictors of progression of diabetic retinopathy (DR) over a 10-year period. DESIGN: Cohort study. PARTICIPANTS: Nine hundred and eighty First Nations patients with diabetes that underwent at least 2 teleophthalmology examinations during the study period. METHODS: Patients underwent serial laboratory testing, and stereoscopic, mydriatic, retinal photography. Modified Early Treatment Diabetic Retinopathy Study grading of retinal images was performed via teleophthalmology. Progression was defined as an increase of 2 or more steps on the Diabetes Control and Complications Trial classification. RESULTS: At baseline, most patients had no diabetic retinopathy (n = 777, 79.3%) whereas 203 people (20.7%) had either nonproliferative DR (n = 179, 18.3%) or proliferative DR (n = 24, 2.5%). Two-step progression occurred in 163 patients (16.6%), with only a minority of these individuals progressing to proliferative DR (n = 23). The median time to progression was 7.6 years. Multivariate Cox regression demonstrated that elevated hemoglobin A1C (hazard ratio [HR] = 1.42; p < 0.0001) and systolic blood pressure (HR = 1.24 per 10 mm Hg; p = 0.009) were independent predictors of progression of DR. CONCLUSIONS: This population-based study has shown that the rate and predictors of progression of DR among First Nations individuals parallels non-First Nations populations, with HbA1C and systolic blood pressure being the strongest predictors. These findings suggest that targeted, individualized care to reduce blood pressure and control blood sugars could reduce progression of diabetic retinopathy, and possibly blindness in First Nations individuals living on reserve.


Subject(s)
Diabetic Retinopathy/ethnology , Indians, North American/ethnology , Alberta/epidemiology , Blood Glucose/metabolism , Blood Pressure , Cohort Studies , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/physiopathology , Disease Progression , Female , Glycated Hemoglobin/metabolism , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , Telemedicine
SELECTION OF CITATIONS
SEARCH DETAIL
...