Prevalence of diabetic retinopathy and reduced vision among indigenous Australians in the nurse-led integrated Diabetes Education and Eye Screening study in a regional primary care clinic.
Female
Humans
Male
Middle Aged
Australia
/ epidemiology
Diabetes Mellitus, Type 2
/ complications
Diabetic Retinopathy
/ diagnosis
Mass Screening
/ methods
Nurse's Role
Prevalence
Primary Health Care
/ methods
Vision Disorders
/ diagnosis
Vision, Low
/ diagnosis
Aged
Patient Education as Topic
/ methods
Health Services, Indigenous
/ supply & distribution
Australian Aboriginal and Torres Strait Islander Peoples
/ statistics & numerical data
diabetes
diabetic retinopathy
indigenous
nurse led
screening
vision
Journal
Internal medicine journal
ISSN: 1445-5994
Titre abrégé: Intern Med J
Pays: Australia
ID NLM: 101092952
Informations de publication
Date de publication:
07 2023
07 2023
Historique:
revised:
05
11
2021
received:
07
10
2021
accepted:
08
11
2021
medline:
24
7
2023
pubmed:
16
11
2021
entrez:
15
11
2021
Statut:
ppublish
Résumé
Nationally, Indigenous Australians are more likely to have diabetes and diabetic retinopathy (DR) than non-Indigenous Australians. However, the prevalence of DR and impaired vision in regional primary care settings is unclear. To describe the prevalence and severity of DR and presenting vision level among Indigenous Australian adults with diabetes attending an indigenous primary care clinic in regional Australia. Participants underwent nurse-led retinal imaging and DR screening with offsite retinal grading in the integrated Diabetes Education and Eye Screening (iDEES) project implemented at a regional indigenous primary healthcare setting between January 2018 and March 2020. Of 172 eligible adults, 135 (79%) were recruited and screened for DR and vision level. The median age was 56 (46-67) years, 130 (96%) had type 2 diabetes of median (interquartile range) duration 6 (2-12) years and 48 (36%) were male. Images from 132 (97.8%) participants were gradable. DR was present in 38 (29%) participants: mild non-proliferative in 33 (25%); moderate-severe in three (2.5%); and sight-threatening two (1.5%). Subnormal presenting vision was present in 33%. A nurse-led model of care integrating diabetes eye screening and education at a single visit was successful at recruiting Indigenous Australian adults with diabetes, screening their vision and acquiring a high rate of gradable images. Even for a short duration of known diabetes, DR was present in three out of 10 patients screened.
Sections du résumé
BACKGROUND
Nationally, Indigenous Australians are more likely to have diabetes and diabetic retinopathy (DR) than non-Indigenous Australians. However, the prevalence of DR and impaired vision in regional primary care settings is unclear.
AIM
To describe the prevalence and severity of DR and presenting vision level among Indigenous Australian adults with diabetes attending an indigenous primary care clinic in regional Australia.
METHODS
Participants underwent nurse-led retinal imaging and DR screening with offsite retinal grading in the integrated Diabetes Education and Eye Screening (iDEES) project implemented at a regional indigenous primary healthcare setting between January 2018 and March 2020.
RESULTS
Of 172 eligible adults, 135 (79%) were recruited and screened for DR and vision level. The median age was 56 (46-67) years, 130 (96%) had type 2 diabetes of median (interquartile range) duration 6 (2-12) years and 48 (36%) were male. Images from 132 (97.8%) participants were gradable. DR was present in 38 (29%) participants: mild non-proliferative in 33 (25%); moderate-severe in three (2.5%); and sight-threatening two (1.5%). Subnormal presenting vision was present in 33%.
CONCLUSIONS
A nurse-led model of care integrating diabetes eye screening and education at a single visit was successful at recruiting Indigenous Australian adults with diabetes, screening their vision and acquiring a high rate of gradable images. Even for a short duration of known diabetes, DR was present in three out of 10 patients screened.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1188-1195Subventions
Organisme : University of Melbourne
ID : 780535
Organisme : University of Sydney
Organisme : NHMRC Practitioner Fellowship
Informations de copyright
© 2021 Royal Australasian College of Physicians.
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