短篇报告：在专科视网膜门诊就诊的高危糖尿病患者中，糖尿病护理欠佳。

Short report: suboptimal diabetes care in high-risk diabetic patients attending a specialist retina clinic.

机构信息

Division of Endocrinology and Metabolism, University of Alberta, Edmonton, AB, Canada.

出版信息

Diabet Med. 2009 Dec;26(12):1296-300. doi: 10.1111/j.1464-5491.2009.02862.x.

DOI:10.1111/j.1464-5491.2009.02862.x

PMID:20002485

Abstract

AIMS

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.

摘要

目的

患有糖尿病视网膜病变（DR）的个体属于高危人群，他们将从强化代谢控制和危险因素管理中获益。本简要报告研究了在一家三级视网膜诊所就诊的糖尿病患者的护理质量。

方法

对 139 名在专科视网膜诊所就诊的糖尿病患者进行了横断面调查、病历回顾和裂隙灯检查，以评估全面糖尿病护理的质量。DR 根据早期糖尿病视网膜病变研究（Etdrs）的标准进行分级。

结果

无 DR、非增殖性 DR（NPDR）和增殖性 DR（PDR）的患病率分别为 39.6%、35.2%。无 DR、NPDR 和 PDR 患者的微量白蛋白尿患病率分别为 32%、54.1%和 68.8%。血糖控制不理想（平均 HbA1c 为 8.0±1.8%），15.8%的患者为当前吸烟者。同时患有 DR 和微量白蛋白尿的患者中，只有 61.9%使用了影响肾素-血管紧张素系统的药物，只有 35.3%使用了阿司匹林。