Methodology and early findings of the Diabetes Management Project: A cohort study investigating the barriers to optimal diabetes care in diabetic patients with and without diabetic retinopathy

Ecosse Luc Lamoureux, Eva K. Fenwick, Jing-JIng Xie, Annie Mcauley, Theona Nicolaou, Melanie Larizza, Gwyn Rees, Salmaan Al-Qureshi, Tien Yin Wong, Rehab Benarous, Mohamed Dirani

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Abstract

Abstract: Background: The Diabetes Management Project is investigating the clinical, behavioural and psychosocial barriers to optimal diabetes care in individuals with and without diabetic retinopathy. Design: Prospective cohort. Participants: Two hundred and twenty-three and 374 patients without and with diabetic retinopathy, respectively. Methods: All individuals underwent a comprehensive dilated eye test, anthropometric measurements, blood and urine samples, and psychosocial questionnaires. Main Outcome Measures: Good glycaemic control was defined as glycosylated haemoglobin<7%, good blood pressure control as systolic and diastolic values ≤130 and 80mmHg, respectively, and good diabetes control as glycosylated haemoglobin<7% and blood pressure values ≤130 and 80mmHg. Results: Four hundred and one males (65.4%) and 212 females (34.6%) aged 26-90years (mean age±standard deviation=64.6±11.6) were examined. The median glycosylated haemoglobin for all participants was 7.5% (interquartile range=1.7%). Average systolic and diastolic blood pressure values were 139.7mmHg (standard deviation=18.8) and 92.7mmHg (standard deviation=30.9), respectively. Initial data analyses indicate that over two-thirds of participants with diabetes have poor glycaemic control, which was worse in those with diabetic retinopathy compared with those without (76.3% vs. 49.3%; P<0.001). Blood pressure control was similar for those with and without diabetic retinopathy, with almost a third (28.5%) of the total sample having poor blood pressure control. Overall, those with diabetic retinopathy had poorer diabetes control than those without (24.3% vs. 13.7%; P=0.002). Conclusions: Our findings substantiate the implementation of the Diabetes Management Project, developed to assess factors associated with suboptimal diabetes care.

Original languageEnglish
Pages (from-to)73-82
Number of pages10
JournalClinical and Experimental Ophthalmology
Volume40
Issue number1
DOIs
Publication statusPublished - Feb 2012
Externally publishedYes

Keywords

  • Barrier
  • Diabetes
  • Diabetic retinopathy
  • Methodology
  • Protocol

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