Roberts R, Speight L, Lee J, George L, Ketchell R I, Lau D, Duckers J
All Wales Adult Cystic Fibrosis Centre, University Hospital Llandough, Cardiff, CF64 2XX, United Kingdom.
All Wales Adult Cystic Fibrosis Centre, University Hospital Llandough, Cardiff, CF64 2XX, United Kingdom.
J Cyst Fibros. 2015 Mar;14(2):282-4. doi: 10.1016/j.jcf.2014.07.014. Epub 2014 Sep 13.
The National Screening Committee recommends annual retinal screening for all diabetic patients over the age of twelve years. Currently, patients on insulin therapy for Cystic Fibrosis-Related Diabetes Mellitus (CFRD) at the All Wales Adult Cystic Fibrosis Service, UK are invited for annual screening.
Age, sex, FEV(1)%, BMI, HbA1c, duration of diabetes, duration of insulin therapy, presence of retinopathy and attendance at retinal screening in 2012 were examined for patients on insulin therapy for CFRD.
67 of the 228 (29%) patients attending the CF centre were receiving insulin therapy. 24 of the 67 (36%) did not attend retinal screening in 2012. Of the 43 who had retinal scans, 18 (42%) had evidence of retinopathy. Patients with retinopathy had a higher mean HbA1c (p=0.04), mean duration of diabetes and mean duration on insulin (p<0.001).
Almost half of the patients screened had evidence of retinopathy but over a third of the patients with CFRD did not attend screening appointments. Improving patient uptake of retinal scans will become increasingly important in an ageing CF population.
国家筛查委员会建议对所有12岁以上的糖尿病患者进行年度视网膜筛查。目前，英国全威尔士成人囊性纤维化服务中心接受胰岛素治疗的囊性纤维化相关糖尿病（CFRD）患者会被邀请参加年度筛查。
对接受CFRD胰岛素治疗的患者的年龄、性别、第1秒用力呼气量（FEV₁）%、体重指数（BMI）、糖化血红蛋白（HbA₁c）、糖尿病病程、胰岛素治疗时长、视网膜病变情况以及2012年视网膜筛查的就诊情况进行了检查。
在228名前往囊性纤维化中心就诊的患者中，67名（29%）正在接受胰岛素治疗。其中，67名患者中有24名（36%）未参加2012年的视网膜筛查。在接受视网膜扫描的43名患者中，18名（42%）有视网膜病变迹象。患有视网膜病变的患者平均糖化血红蛋白水平更高（p = 0.04），糖尿病平均病程和胰岛素平均使用时长也更长（p < 0.001）。
几乎一半接受筛查的患者有视网膜病变迹象，但超过三分之一的CFRD患者未参加筛查预约。在囊性纤维化患者老龄化的情况下，提高患者对视网膜扫描检查的接受度将变得越来越重要。
