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

Authors

  • Ecosse Luc Lamoureux PhD,

    Corresponding author
    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
    2. Singapore Eye Research Institute, Singapore
      A/Professor Ecosse Lamoureux, Centre for Eye Research Australia, 32 Gisborne Street, East Melbourne, Vic. 3002, Australia. Email: ecosse@unimelb.edu.au
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  • Eva Fenwick MA,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Jing Xie PhD,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Annie Mcauley BSc(Hons),

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Theona Nicolaou BScOrth,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Melanie Larizza BScPsy,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Gwyn Rees PhD,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Salmaan Qureshi FRANZCO,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Tien Yin Wong PhD,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
    2. Singapore Eye Research Institute, Singapore
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  • Rehab Benarous MBBS,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Mohamed Dirani PhD

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Conflict/competing interest: No stated conflict of interest.

  • Funding sources: The Australian Research Council (LP0884108) and partial support from the National Health and Medical Research Council Centre for Clinical Research Excellence #529923-Translational Clinical Research in Major Eye Diseases.

A/Professor Ecosse Lamoureux, Centre for Eye Research Australia, 32 Gisborne Street, East Melbourne, Vic. 3002, Australia. Email: ecosse@unimelb.edu.au

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 80 mmHg, respectively, and good diabetes control as glycosylated haemoglobin < 7% and blood pressure values ≤130 and 80 mmHg.

Results:  Four hundred and one males (65.4%) and 212 females (34.6%) aged 26–90 years (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 139.7 mmHg (standard deviation = 18.8) and 92.7 mmHg (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.

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