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Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS)

OBJECTIVE: To determine the prevalence and risk factors of diabetic retinopathy in the inpatient diabetic population in the USA and to determine the barriers to ophthalmic examinations and treatment among this population. RESEARCH DESIGN AND METHODS: A cross-sectional analysis of 113 inpatients with...

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Autores principales: Kovarik, Jessica J, Eller, Andrew W, Willard, Lauren A, Ding, Jiaxi, Johnston, Jann M, Waxman, Evan L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761984/
https://www.ncbi.nlm.nih.gov/pubmed/26925238
http://dx.doi.org/10.1136/bmjdrc-2015-000164
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author Kovarik, Jessica J
Eller, Andrew W
Willard, Lauren A
Ding, Jiaxi
Johnston, Jann M
Waxman, Evan L
author_facet Kovarik, Jessica J
Eller, Andrew W
Willard, Lauren A
Ding, Jiaxi
Johnston, Jann M
Waxman, Evan L
author_sort Kovarik, Jessica J
collection PubMed
description OBJECTIVE: To determine the prevalence and risk factors of diabetic retinopathy in the inpatient diabetic population in the USA and to determine the barriers to ophthalmic examinations and treatment among this population. RESEARCH DESIGN AND METHODS: A cross-sectional analysis of 113 inpatients with diabetes mellitus admitted to an inner city community teaching hospital in Pittsburgh. Digital fundus photographs of the posterior pole were taken of each eye after pharmacological dilation. Presence, absence and severity of diabetic retinopathy and macular edema were graded on the basis of internationally accepted criteria. An investigator-administered questionnaire and review of the medical record were used to obtain data about patient demographics, clinical characteristics and barriers to ophthalmic care. The association between these data and the presence of diabetic retinopathy was tested. RESULTS: The estimated prevalence of diabetic retinopathy in the inpatient population was 44% (95% CI 34% to 53%). The prevalence of previously undiagnosed diabetic retinopathy and sight-threatening retinopathy was 25% (95% CI 17% to 33%) and 19% (95% CI 11% to 26%), respectively. Renal disease was independently associated with the presence of diabetic retinopathy (OR, 3.86; 95% CI 1.22 to 12.27), as well as a longer duration of diabetes (OR, 1.08 per year; 95% CI 1.014 to 1.147). Diabetic retinopathy was seen in 15 of 17 patients admitted with diabetic foot ulcers or osteomyelitis. Frequently reported barriers to ophthalmic examinations included lack of transportation and physical disability. CONCLUSIONS: The prevalence of diabetic retinopathy and sight-threatening diabetic retinopathy in the inpatient population is likely significantly higher than in the general diabetic population in the USA. These patients have barriers to care that need to be addressed to make standard of care ophthalmic examinations and treatment possible in this population.
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spelling pubmed-47619842016-02-26 Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS) Kovarik, Jessica J Eller, Andrew W Willard, Lauren A Ding, Jiaxi Johnston, Jann M Waxman, Evan L BMJ Open Diabetes Res Care Epidemiology/Health Services Research OBJECTIVE: To determine the prevalence and risk factors of diabetic retinopathy in the inpatient diabetic population in the USA and to determine the barriers to ophthalmic examinations and treatment among this population. RESEARCH DESIGN AND METHODS: A cross-sectional analysis of 113 inpatients with diabetes mellitus admitted to an inner city community teaching hospital in Pittsburgh. Digital fundus photographs of the posterior pole were taken of each eye after pharmacological dilation. Presence, absence and severity of diabetic retinopathy and macular edema were graded on the basis of internationally accepted criteria. An investigator-administered questionnaire and review of the medical record were used to obtain data about patient demographics, clinical characteristics and barriers to ophthalmic care. The association between these data and the presence of diabetic retinopathy was tested. RESULTS: The estimated prevalence of diabetic retinopathy in the inpatient population was 44% (95% CI 34% to 53%). The prevalence of previously undiagnosed diabetic retinopathy and sight-threatening retinopathy was 25% (95% CI 17% to 33%) and 19% (95% CI 11% to 26%), respectively. Renal disease was independently associated with the presence of diabetic retinopathy (OR, 3.86; 95% CI 1.22 to 12.27), as well as a longer duration of diabetes (OR, 1.08 per year; 95% CI 1.014 to 1.147). Diabetic retinopathy was seen in 15 of 17 patients admitted with diabetic foot ulcers or osteomyelitis. Frequently reported barriers to ophthalmic examinations included lack of transportation and physical disability. CONCLUSIONS: The prevalence of diabetic retinopathy and sight-threatening diabetic retinopathy in the inpatient population is likely significantly higher than in the general diabetic population in the USA. These patients have barriers to care that need to be addressed to make standard of care ophthalmic examinations and treatment possible in this population. BMJ Publishing Group 2016-02-16 /pmc/articles/PMC4761984/ /pubmed/26925238 http://dx.doi.org/10.1136/bmjdrc-2015-000164 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Epidemiology/Health Services Research
Kovarik, Jessica J
Eller, Andrew W
Willard, Lauren A
Ding, Jiaxi
Johnston, Jann M
Waxman, Evan L
Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS)
title Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS)
title_full Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS)
title_fullStr Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS)
title_full_unstemmed Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS)
title_short Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS)
title_sort prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (drips)
topic Epidemiology/Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761984/
https://www.ncbi.nlm.nih.gov/pubmed/26925238
http://dx.doi.org/10.1136/bmjdrc-2015-000164
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