Title

A COMMUNITY-BASED SCREENING CAMPAIGN FOR THE DETECTION OF DIABETES MELLITUS COMPLICATIONS USING DIABETIC RETINOPATHY AS BIOMARKER

Introduction

This project describes a mass screening campaign for the detection of diabetes complications using diabetic retinopathy (DR) as a biomarker

Methods

Patients were recruited from community with previous diagnostic of diabetes. They underwent a series of exams which started with fundoscopy for DR detection, then diabetic feet exam. Patients were classified according to ETDRS classification and if they had severe or worse DR they were also evaluated for diabetic nephropathy using proteinuria as reference. All patients with proliferative disease were referenced for laser photocoagulation. After diabetic feet exam, patients with low sensibility using 10g monofilament test were avaluated for diabetic footwear adaption. If distal pulse were absent or in presence of ulcer/amputation they were examined by the vascular surgeon at the event and referenced if necessary

Results

A total of 568 diabetic patients were examined. The mean age was 60.1 years old, 55.93% female and 44.07% male. The majority of patients had type 2 diabetes (94.8%). The mean time of diabetes was 11.52 years. For 48.27% this was the first time they had dilated indirect ophthalmoscopy performed and for 69.96% the first time they had detailed feet examination. Regarding DR 85.77% had normal eye exam, 9.55% had moderate or better, and 4.68% had severe or worse DR. A total of 16 eyes had diabetic macular edema. 2 patients were diagnosed with traction retinal detachment and 6 with vitreous hemorrhage which were referred for vitreoretinal surgery. 152 patients were newly diagnosed with low feet sensibility and referred for specific footwear adaption. 38 patients were submitted to proteinuria test and blood pressure, 63.89% were positive and referred for complete nephrological exam

Discussion

It was able to detect and treat patients with complications in a single day. This model gives easy access to perform specialized screening tests in the public health system. In long term, severe complications could be reduced.

Keywords

Diabetic Retinopathy, Screening Campaign, Public Health

Area

CLINICAL CASE

Authors

Julia Simones, Alan França Cerioli, Fernando Marcondes Penha