Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Transl Vis Sci Technol. 2024 Sep 3;13(9):6. doi: 10.1167/tvst.13.9.6.
Long-term ramifications of the coronavirus disease 2019 pandemic on various care-seeking characteristics of patients with diabetic retinopathy remain unclear. This study aimed to identify risk factors for dropout from regular fundus examinations (RFEs) in patients with diabetic retinopathy in Japan.
We extracted demographic and health checkup data (April 2018 to March 2021) from the JMDC database. Patients with diabetes identified using diagnosis-related and medication codes were included. The dropout and continuation groups included patients who discontinued and continued to undergo RFEs during the coronavirus disease 2019 pandemic, respectively.
The number of RFEs was significantly lower during the mild lockdown period (April and May 2020) than during the prepandemic period. Of the 14,845 patients with diabetes, 2333 (15.7%) dropped out of RFEs during the pandemic, whereas before the pandemic, of the 11,536 patients with diabetes, 1666 (14.4%) dropped out of RFEs (P = 0.004). Factors associated with dropout in the multivariate logistic regression analysis included younger age, male sex, high triglyceride levels, high γ-glutamyl transpeptidase levels, smoking habit, alcohol consumption, weight gain of more than 10 kg since the age of 20 years, and certain stages of lifestyle improvement. Factors associated with continuation included low body mass index and high glycosylated hemoglobin levels.
Our findings can assist in identifying patients with diabetes at risk of dropout.
These results have implications for public health and identifying patients with diabetes at risk of dropout. Education and tailored monitoring regimens could be pivotal role in fostering adherence.
新冠疫情对糖尿病视网膜病变患者各种求诊特征的长期影响尚不清楚。本研究旨在确定日本糖尿病视网膜病变患者退出定期眼底检查（RFE）的风险因素。
我们从 JMDC 数据库中提取了 2018 年 4 月至 2021 年 3 月的人口统计学和健康检查数据。使用与诊断和药物相关的代码确定患有糖尿病的患者。脱落组和继续组分别包括在新冠疫情期间停止和继续接受 RFE 的患者。
在轻度封锁期间（2020 年 4 月和 5 月），RFE 的数量明显低于大流行前时期。在 14845 名患有糖尿病的患者中，有 2333 名（15.7%）在疫情期间退出了 RFE，而在大流行前，在 11536 名患有糖尿病的患者中，有 1666 名（14.4%）退出了 RFE（P=0.004）。多变量逻辑回归分析中与脱落相关的因素包括年龄较小、男性、高甘油三酯水平、高γ-谷氨酰转肽酶水平、吸烟习惯、饮酒、20 岁以后体重增加超过 10 公斤，以及某些生活方式改善阶段。与继续相关的因素包括低体重指数和高糖化血红蛋白水平。
我们的发现可以帮助识别有脱落风险的糖尿病患者。
乔林
