Diabetic retinopathy common in hospitalized diabetics

By David Douglas

NEW YORK (Reuters Health) - Close to half of hospitalized diabetics have diabetic retinopathy and the condition has not been previously diagnosed in about a quarter, according to a small study from Pennsylvania.

"Our study shows that people with diabetes who have been in the hospital have an especially high rate of diabetic eye disease and suggests that scheduling an eye exam is an important part of discharge planning for someone with diabetes," Dr. Evan L. Waxman from the University of Pittsburgh School of Medicine told Reuters Health by email.

In a paper online February 16 in BMJ Open Diabetes Research and Care, Dr. Waxman and colleagues note that the estimated prevalence of retinopathy in U.S. diabetics is 28.5%. For sight-threatening retinopathy, the corresponding proportion is 4.4%. However, information is lacking about the hospital population.

To investigate, the researchers conducted a cross-sectional analysis of 113 inpatients with diabetes mellitus admitted to UPMC Mercy Hospital in Pittsburgh, an inner-city community teaching hospital.

The overall prevalence of diabetic retinopathy was 44%, in line with findings in an Israeli and in a German study of hospital inpatients. For previously undiagnosed retinopathy, the figure was 25% and for sight-threatening retinopathy it was 19%.

Renal disease was independently and significantly associated with the presence of diabetic retinopathy (odds ratio, 3.86) as was a longer diabetes duration (OR, 1.08 per year). Also, 15 of 17 patients admitted with diabetic foot ulcers or osteomyelitis showed diabetic retinopathy.

"Many people who know they have diabetes don't make it to the eye doctor," said Dr. Waxman. "There are all sorts of reasons: they don't have the time, they have too many other doctor's appointments or they have problems with transportation. In too many cases though, people just didn't know they needed an eye exam because they thought that because they were seeing well their eyes must be fine."

The investigators say "the outcomes and cost-effectiveness of routine inclusion of the scheduling of an eye examination as part of discharge planning and/or the routine use of retinal photographic screening during hospitalization should be examined."

SOURCE: bit.ly/21yQrFj

BMJ Open Diab Res Care 2016.

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