AIM： To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China.METHODS： A structured intervi...AIM： To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China.METHODS： A structured interview including questions on attendance of eye screening, knowledge and awareness of diabetic retinopathy was conducted. The presence and degree of retinopathy were assessed using two field nonmydriatic retinal photography. RESULTS： Totally 720 diabetes persons were recruited and 519 were enrolled in this cross-sectional study. In this urban setting of Beijing, among diabetes patients of average of 10 y duration, 77% confirmed having undergone at least one eye examination and 61% reported having at least one eye examination with dilated pupil. As for the last 12 mo, the number decreased to 210（47%） and 131（30%） separately. Most of the participants（95%） were aware that diabetes could affect their vision and that regular eye examination was necessary. Very few of them（12%） however were aware that the early stages of diabetic retinopathy presented without symptoms of vision loss. Having attended patient education on diabetes was effective in building awareness about diabetic eye disease and was a significant positive predictor for attending eye screening [education in a year, Adj. OR=0.47（0.29-0.74）, P〈0.001, education years ago, Adj. OR=0.56（0.33-0.96）, P=0.036]. The duration of disease also increasedthe likelihood of having undergone eye screening（Adj. OR=0.96, P〈0.05）. CONCLUSION： Being exposed to education about the complications of diabetes increases the probability of attending diabetic eye screening. An appropriate patient knowledge building strategy should be made available to patients from the time of diagnosis.展开更多
International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational ...International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.展开更多
基金Supported by the National Natural Science Foundation of China(No.81273159)Capital Medical Development Research Fund(No.2009-2034)
文摘AIM： To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China.METHODS： A structured interview including questions on attendance of eye screening, knowledge and awareness of diabetic retinopathy was conducted. The presence and degree of retinopathy were assessed using two field nonmydriatic retinal photography. RESULTS： Totally 720 diabetes persons were recruited and 519 were enrolled in this cross-sectional study. In this urban setting of Beijing, among diabetes patients of average of 10 y duration, 77% confirmed having undergone at least one eye examination and 61% reported having at least one eye examination with dilated pupil. As for the last 12 mo, the number decreased to 210（47%） and 131（30%） separately. Most of the participants（95%） were aware that diabetes could affect their vision and that regular eye examination was necessary. Very few of them（12%） however were aware that the early stages of diabetic retinopathy presented without symptoms of vision loss. Having attended patient education on diabetes was effective in building awareness about diabetic eye disease and was a significant positive predictor for attending eye screening [education in a year, Adj. OR=0.47（0.29-0.74）, P〈0.001, education years ago, Adj. OR=0.56（0.33-0.96）, P=0.036]. The duration of disease also increasedthe likelihood of having undergone eye screening（Adj. OR=0.96, P〈0.05）. CONCLUSION： Being exposed to education about the complications of diabetes increases the probability of attending diabetic eye screening. An appropriate patient knowledge building strategy should be made available to patients from the time of diagnosis.
文摘International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.
