Epidemiology of diabetic retinopathy: Expected vs reported prevalence of cases in the French population

Delcourt, Cécile; Massin, Pascale; Rosilio, Myriam

doi:10.1016/j.diabet.2009.06.002

Cited by 57 publications

(35 citation statements)

References 31 publications

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“…In 2009, there were only 5 567 ophthalmologists, which equates to one for every 520 persons with diabetes [27]. The growing number of people with diabetes and the decreasing number of ophthalmologists able to perform fundoscopic examinations has been cited as a contributing factor to access problems [31]. To address this challenge, French regions have deployed various innovative methods to screen for diabetic retinopathy, ranging from the Ophdiat telemedical network in the Ile-de-France [32] to Bourgogne’s mobile screening units [33].…”

Section: Resultsmentioning

confidence: 99%

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The burden and treatment of diabetes in France

Chevreul

Brigham

Bouché

2014

Globalization and Health

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BackgroundThe objective of this review was to describe and situate the burden and treatment of diabetes within the broader context of the French health care system.MethodsLiterature review on the burden, treatment and outcomes of diabetes in France, complemented by personal communication with with diabetes experts in the Paris public hospital system.ResultsPrevalence of diabetes in the French population is estimated at 6%. Diabetes has the highest prevalence among all chronic conditions covered 100% by France’s statutory health insurance (SHI), and the number of covered patients has doubled in the past 10 years. In 2010, the SHI cost for pharmacologically-treated diabetes patients amounted to €17.7 billion, including an estimated €2.5 billion directly related to diabetes treatment and prevention and €4.2 billion for treatment of diabetes-related complications. In 2007, the average annual SHI cost was €6 930 for patients with type 1 diabetes and €4 890 for patients with type 2 diabetes. Complications are associated with significantly increased costs. Diabetes is a leading cause of adult blindness, amputation and dialysis in France, which also has one of the highest rates of end-stage renal disease in Europe. Cardiovascular disease is the leading cause of death among people with diabetes. Historically, the French health care system has been more oriented to curative acute care rather than preventive medicine and management of long-term chronic diseases. More recently, the government has focused on primary prevention as part of its national nutrition and health program, with the goal of reducing overweight and obesity in adults and children. It has also recognized the critical role of the patient in managing chronic diseases such as diabetes and has put into place a free patient support program called “sophia”. Additional initiatives focus on therapeutic patient education (TPE) and the development of personalized patient pathways.ConclusionsWhile France has been successful in protecting patients from the financial consequences of diabetes through its SHI coverage, improvements are necessary in the areas of prevention, monitoring and reducing the incidence of complications. Systemic changes must be made to improve the coordination and delivery of chronic care.

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Section: Resultsmentioning

confidence: 99%

“…However, the significant consequences of these complications underscore the importance of better understanding their burden. Diabetes is a leading cause of adult blindness, [31] amputation [50] and dialysis [51] in France, and cardiovascular disease is the leading cause of death among people with diabetes [49]. …”

Section: Resultsmentioning

confidence: 99%

The burden and treatment of diabetes in France

Chevreul

Brigham

Bouché

2014

Globalization and Health

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“…However, several studies indicate that a large proportion of the diabetic population does not follow the recommended guidelines to prevent visual impairment and blindness and their retinal status is unknown [18,19,20]. This can probably be explained by a lack of awareness of the need for eye care, especially with no previous diabetes education, and in the absence of symptoms [21].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a Mobile Diabetic Retinopathy Screening Campaign to Encourage Diabetics to Undergo Regular Ophthalmic Follow-Up

Creuzot‐Garcher

Martin-Phipps²,

Beynat³

et al. 2014

Ophthalmic Res

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Aim: To evaluate the effectiveness of a mobile diabetic retinopathy (DR) screening campaign with a non-mydriatic camera to encourage diabetics to undergo a subsequent ophthalmic follow-up. Methods: Diabetic patients who underwent free DR screening with a non-mydriatic fundus camera were given the recommendation to have an ophthalmic visit, in a time frame suited to the DR stage or in case abnormalities in the macula, the optic nerve or intra-ocular pressure were detected. The photographs were performed by a trained orthoptist. The date of the visit to their ophthalmologist and the report of this consultation were recorded. Results: During 5 annual campaigns, 4,699 diabetics were screened. Of the 1,573 ophthalmic examinations recommended at the screening, 1,241 (79%) were actually conducted. A total of 623 new cases of DR were found in the course of this screening campaign, with a fair concordance between the diagnosis suggested at screening and the examination by the ophthalmologist (κ = 0.48). Conclusion: Information and recommendations given during DR screening helped to reintroduce patients to a regular ophthalmic follow-up, at least in the short term.

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“…Sa prévalence était chiffrée en 2009 à 4,4 % [2]. Parmi les patients diabétiques de type 2, 33 % souffrent de rétinopa-thie diabétique (RD) et 5,6 % d'oedème maculaire diabétique (OMD) [3]. Les départements les plus touchés par le diabète de type 2 sont les départements d'Outre-mer, et du Nord-Est de la France, ainsi que la Seine-Saint-Denis (SSD) avec une prévalence de 5,8 % [2].…”

Section: Introductionunclassified