Within the first 10 years of diabetes duration, the prevalence of retinopathy is low and the progression infrequent. Most patients have a non-proliferative form which can be reversible and rarely requires interventions. Patients with DM2 without retinopathy and good glycaemic control do not run into additional risk from expanding funduscopy intervals to biennial.
Objective The quality report of the disease management programmes of North Rhine Westphalia 2016 showed prevalences for long-term complications (neuropathy, nephropathy, retinopathy) of less than 30% for people with diabetes type 1 (DM1) and type 2 (DM2). The aim of this study was to assess risk expectations and fear regarding long-term complications of diabetes in people with DM1 and DM2.
Methods We assessed risk expectations and fear regarding diabetes complications in people with DM1 (n=110) and DM2 (n=143 without insulin, n=249 with insulin) visiting an University outpatient department of metabolic diseases. Fear of long-term complications was measured with the “Fear of Complications Questionnaire (FCQ)” (range 0–45 points, scores ≥30 suggest elevated fear). Participants were asked to estimate general and personal risks of long-term complications 10 years after developing diabetes in %.
Results Elevated fear of complications (FCQ scores ≥30) was observed in 34.5, 25.9, and 43.0% of those with DM1, DM2 without insulin and DM2 with insulin, respectively. Participants estimated a mean general risk of diabetes-related complications after 10 years amounting to 45.9±15.8% (DM1), 49.7±15.4% (DM2 without insulin), and 52.5±16.4% (DM2 with insulin) and personal risk with 52.5±24.4% (DM1), 45.8±22.7% (DM2 without insulin), and 54.1±23.4% (DM2 with insulin), respectively. Higher risk expectations were associated with higher fear of complications (p<0.001).
Conclusion Risk estimations regarding long-term complications were exaggerated in people with DM1 and DM2. About one third of the participants reported elevated fear of complications. Participants’ risk expectations and fear regarding diabetes complications appear excessive compared to population-based prevalence rates.
Aims No information exists on the frequency of visual impairment in people
with diabetes mellitus (DM) in Germany. In this study, the prevalence of vision
impairment in those individuals was investigated.
Methods We retrospectively analyzed a cohort of 295 people (14221
consultations) at a university outpatient clinic with any type of DM and an
available ETDRS-Score and visual acuity. The primary outcome was the prevalence
of visual impairment, the secondary outcome was the correlation of the
ETDRS-Score and limitations of visual acuity and the prevalence of higher
ETDRS-Score with a visual impairment defined as a
decimal-visus</=0.3.
Results The prevalence of visual impairment in participants with DM was
11.2%; among these individuals, 81.8% had no or
non-proliferative retinopathy. In the DM2 subgroup, 81.5% (n=22)
of the visually impaired participants had no DR, in contrast to only
16.7% (n=1) in the DM1 subgroup. Progression in ETDRS-Score led
to worse visual acuity (r=−0.209; p<0.001). A
significantly related covariates with impairment of the visual acuity for
individuals with DM1 was the duration of diabetes (B=−0.007;
p=0.001) and for individuals with DM2, the age
(B=−0.008; p=0.009).
Conclusions The prevalence of impaired vision in people with diabetes in
our cohort was 11.2%,<20% of visual impairment in people
with diabetes is caused by diabetic retinopathy, and 69.7% of
participants with visual impairment had no DR. In our study patients without
visual impairment showed a similar distribution of DR severity levels regardless
of the type of diabetes.
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