Presentation laddar. Vänta.

Presentation laddar. Vänta.

FoU-centrum Primärvård och Tandvård i Skaraborg Does treatment for hypertension protect against retinopathy? Skaraborgs Diabetesregister (SDR) ten years.

Liknande presentationer


En presentation över ämnet: "FoU-centrum Primärvård och Tandvård i Skaraborg Does treatment for hypertension protect against retinopathy? Skaraborgs Diabetesregister (SDR) ten years."— Presentationens avskrift:

1 FoU-centrum Primärvård och Tandvård i Skaraborg Does treatment for hypertension protect against retinopathy? Skaraborgs Diabetesregister (SDR) ten years follow up Grete Garberg, MD Skaraborg Hospital

2 FoU-centrum Primärvård och Tandvård i Skaraborg Background I Diabetic retinopathy main reason for visual impairment in working ages, patients fear ”blindness” Important to prevent Type 2 diabetes retinopathy not unusual at diagnosis Screening is effective to detect retinopathy makes treatment possible before symptoms evolve

3 FoU-centrum Primärvård och Tandvård i Skaraborg Background II Screening in Skaraborg from late 1980 patients in ages < 70 years Skaraborgs Diabetes Register (SDR) clinical data and data on morbidity and mortality Patients type 2 (+0=undefined)diagnosed the basis of this study

4 FoU-centrum Primärvård och Tandvård i Skaraborg SDR cohort (305dead) 381≥70yrs at baseline (187dead) 877 < 70yrs at baseline (118dead) 6 undefined 2 type1 403 type2 8 undefined 104 type1 765 type2 Population SDR=Skaraborgs diabetesregister

5 FoU-centrum Primärvård och Tandvård i Skaraborg Methods Data from retinal screening close to diagnosis and after 5 and 10 years From screening records retinopathy, maculopathy, laser treatment, visual acuity and other reasons for visual impairment From Skaraborgs Diabetes Register HbA1c, body mass index (BMI), blood pressure (BP) and antihypertensive treatment

6 FoU-centrum Primärvård och Tandvård i Skaraborg Results I a Diabetic retinopathy in all patients (type 1+2+0) *Before 01/01/99, ** Before 01/01/03, *** Before 10/08/09, § last examination Number of patients Examination Examination Examination § Examined Any retinopathy Maculopathy51938 Proliferative retinopathy 0512 Laser treatment A maculopathy B scatter (1 BRVO) Visual acuity  >0.5  < Mortality22*57**117***

7 FoU-centrum Primärvård och Tandvård i Skaraborg Results I Diabetic retinopathy in patients type 0+2 <70 years at baseline *Before 01/01/99, ** Before 01/01/03, *** Before 10/08/09, § last examination Number of patients Examination Examination Examination § Examined Any retinopathy (25,6%) Maculopathy31532(5,7%) Proliferative retinopathy 027 (1.4%) Laser treatment A maculopathy B scatter (3.4%) 18 6 (1 BRVO) Visual acuity  >0.5  < Mortality20*53**114***

8 FoU-centrum Primärvård och Tandvård i Skaraborg Results summary I Frequency of screening 83% (639/773) of patients <70 years at diagnosis screened some time during follow-up HbA1C at diagnosis Mean value 6,66% Visual acuity 96% (527/548) >0.5 at the last recorded examination

9 FoU-centrum Primärvård och Tandvård i Skaraborg HbA1C at diagnosis

10 FoU-centrum Primärvård och Tandvård i Skaraborg HbA1c< 7.0 %≥7.0 %p Retinopathy88 (22.4%)71 (38.6%)< Maculopathy15 (4.0%)18 (9.8%)0.006 HbA1c< 8.0 %≥8.0 %p Retinopathy114 (24.4%)45 (41.7%)< Maculopathy20 (4.4%)13 (11.9%)0.003 Results IIa HbA1C in

11 FoU-centrum Primärvård och Tandvård i Skaraborg Results IIb HbA1C and time to retinopathy

12 FoU-centrum Primärvård och Tandvård i Skaraborg Results IIc HbA1C and time to maculopathy

13 FoU-centrum Primärvård och Tandvård i Skaraborg Results IId BMI in and retinopathy

14 FoU-centrum Primärvård och Tandvård i Skaraborg Results IIe BMI in and maculopathy

15 FoU-centrum Primärvård och Tandvård i Skaraborg Results IIIa Blood pressure and hypertension Systolic blood pressure <130 mmHg Associated with less retinopathy Systolic blood pressure >130 mmHg Further increase in systolic blood pressure not associated with more retinopathy. Blood pressure at baseline Not associated with retinopathy or maculopathy Hypertension treatment at baseline Associated with less retinopathy

16 FoU-centrum Primärvård och Tandvård i Skaraborg Results IIIb Antihypertensive treatment and retinopathy

17 FoU-centrum Primärvård och Tandvård i Skaraborg Results IIIc Antihypertensive treatment and maculoopathy

18 FoU-centrum Primärvård och Tandvård i Skaraborg Conclusions I Relatively few patients with visual impairment Retinopathy increases rapidly after 10 years duration

19 FoU-centrum Primärvård och Tandvård i Skaraborg Conclusions II HbA 1 C level at diagnosis seems to predict risk for retinopathy and maculopathy BMI at diagnosis does not affect development of retinopathy

20 FoU-centrum Primärvård och Tandvård i Skaraborg Conclusions III Antihypertensive treatment regardless of BP level associated with lower frequency of retinopathy lower frequency of maculopathy

21 FoU-centrum Primärvård och Tandvård i Skaraborg Thank you for your attention! Questions or comments?

22 FoU-centrum Primärvård och Tandvård i Skaraborg Thanks for contribution from R&D Centre, Skaraborg Hospital, financing Bo Berger, PhD Kristina A Boström, Supervisor; PhD, R&D Centre Skaraborg Primary Care Monica Lövestam Adrian, Suprervisor; PhD, Eye Clinic, Lund University Hospital Salmir Nasic, Statistician, Skaraborg Hospital Ann Segerblom, Research Assistent, R&D Centre Skaraborg Primary Care


Ladda ner ppt "FoU-centrum Primärvård och Tandvård i Skaraborg Does treatment for hypertension protect against retinopathy? Skaraborgs Diabetesregister (SDR) ten years."

Liknande presentationer


Google-annonser