Journal ArticleDOI
A Single Visit Diabetes Complication Assessment Service: a Complement to Diabetes Management at the Primary Care Level
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A complication assessment service whereby all the major diabetes‐specific complications were assessed in a single 3 h visit, demonstrating that GPs were very good at following a recommendation to refer a patient for ophthalmic assessment and improving hypertension but were less successful in treating hyperlipidaemia.Abstract:
Modern diabetes management emphasizes the early detection and prompt treatment of diabetic complications. However it is difficult to organize comprehensive screening at the primary care level. To address this problem we established a complication assessment service whereby all the major diabetes-specific complications were assessed in a single 3 h visit. A report with results and recommendations was sent to the general practitioner (GP). Being philosophically a complication-specific service, no attempt was made to intervene with metabolic management. This paper describes our experience with the first 743 patients of whom 92% had been referred from GPs. Of the diabetes-specific complications, 22% of patients had one, 5% had two, and 1% had three major complications. Many of the patients were unaware of the presence of these complications. One hundred and three people had attended the service on more than one occasion with an average time between visits of 1.7 years. The results demonstrated that GPs were very good at following a recommendation to refer a patient for ophthalmic assessment (85% of cases) and improving hypertension but were less successful in treating hyperlipidaemia. This service has proven to be an excellent forum for the collection of data and the teaching of health professionals. It is a move away from the traditional format of hospital-based clinics providing comprehensive diabetes management.read more
Citations
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Journal Article
1998 clinical practice guidelines for the management of diabetes in Canada. Canadian Diabetes Association.
S. Meltzer,Lawrence A. Leiter,D. Daneman,Hertzel C. Gerstein,David C.W. Lau,S. Ludwig,Jean-François Yale,B. Zinman,D. Lillie +8 more
TL;DR: This document contains numerous detailed recommendations pertaining to all aspects of ambulatory diabetes care, ranging from service delivery to prevention and treatment of diabetes-related complications.
Journal Article
1998 clinical practice guidelines for the management of diabetes in Canada
S. Meltzer,Lawrence A. Leiter,D. Daneman,Hertzel C. Gerstein,David C.W. Lau,S. Ludwig,Jean-François Yale,B. Zinman,D. Lillie,Committees. Steering +9 more
TL;DR: The 1992 edition of the clinical practice guidelines for the management of diabetes in Canada incorporating recent advances in diagnosis and outpatient management of diabetic mellitus and to identify and assess the evidence supporting these recommendations were reviewed, revised as required and expressed as a set of recommendations as discussed by the authors.
Journal ArticleDOI
Long-Term Complications and Mortality in Young-Onset Diabetes: Type 2 diabetes is more hazardous and lethal than type 1 diabetes
Maria I. Constantino,Lynda Molyneaux,Lynda Molyneaux,Franziska Limacher-Gisler,Abdulghani Al-Saeed,Connie Luo,Ted Wu,Stephen M. Twigg,Stephen M. Twigg,Dennis K. Yue,Dennis K. Yue,Jencia Wong,Jencia Wong +12 more
TL;DR: Young-onset T2DM is the more lethal phenotype of diabetes and is associated with a greater mortality, more diabetes complications, and unfavorable cardiovascular disease risk factors when compared with T1DM.
Journal ArticleDOI
An Inverse Relationship Between Age of Type 2 Diabetes Onset and Complication Risk and Mortality: The Impact of Youth-Onset Type 2 Diabetes
Abdulghani Al-Saeed,Maria I. Constantino,Lynda Molyneaux,Mario D'Souza,Franziska Limacher-Gisler,Connie Luo,Ted Wu,Stephen M. Twigg,Dennis K. Yue,Jencia Wong +9 more
TL;DR: The negative effect of diabetes on morbidity and mortality is greatest for those diagnosed at a young age compared with T2DM of usual onset, highlighting the growing imperative to direct attention toward young-onset T2 DM and for effective interventions to be applied before middle age.
Journal ArticleDOI
Timing is everything: age of onset influences long-term retinopathy risk in type 2 diabetes, independent of traditional risk factors.
TL;DR: Data suggest an increased inherent susceptibility to diabetic retinopathy with earlier-onset type 2 diabetes, which supports the importance of delaying development of diabetes and also implies a need for more stringent metabolic targets for younger individuals.
References
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Microalbuminuria Predicts Clinical Proteinuria and Early Mortality in Maturity-Onset Diabetes
TL;DR: It is concluded that microalbuminuria in patients with Type II diabetes is predictive of clinical proteinuria and increased mortality.
Journal ArticleDOI
The Wisconsin Epidemiologic Study of Diabetic Retinopathy: II. Prevalence and Risk of Diabetic Retinopathy When Age at Diagnosis Is Less Than 30 Years
TL;DR: In a population-based study in southern Wisconsin, 996 insulin-taking, younger-onset diabetic persons were examined using standard protocols to determine the prevalence and severity of diabetic retinopathy and associated risk variables.
Journal ArticleDOI
The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years.
TL;DR: The severity of retinopathy was found to be related to longer duration of diabetes, younger age at diagnosis, higher glycosylated hemoglobin levels, higher systolic BP, use of insulin, presence of proteinuria, and small body mass.
Journal ArticleDOI
Microalbuminuria Predicts Mortality in Noninsulin-dependent Diabetes
TL;DR: In multivariate analyses age and AER were independent predictors of both mortality and time to death, with AER having the greater degree of significance.
Journal ArticleDOI
Microalbuminuria: a major risk factor in non-insulin-dependent diabetes. A 10-year follow-up study of 503 patients
A. Schmitz,Michael Vaeth +1 more
TL;DR: The impact of microalbuminuria on mortality as well as other risk factors was investigated in a 10‐year follow-up study of 503 predominantly non‐insulin‐dependent diabetic patients of whom 265 had died.
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