Diabetes Care in an Australian Population

Frequency of screening examinations for eye and foot complications of diabetes

  1. Robyn J. Tapp, GRAD DIP12,
  2. Paul Z. Zimmet, MD1,
  3. C. Alex Harper, MD3,
  4. Maximilian P. de Courten, MD1,
  5. Beverley Balkau, PHD4,
  6. Daniel J. McCarty, PHD35,
  7. Hugh R. Taylor, MD3,
  8. Timothy A. Welborn, MD6,
  9. Jonathan E. Shaw, MD1 and
  10. on behalf of the Australian Diabetes Obesity and Lifestyle Study Group
  1. 1International Diabetes Institute, Melbourne, Australia
  2. 2Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
  3. 3Centre for Eye Research Australia, the University of Melbourne, Australia
  4. 4INSERM Unite 258-IFR69, Villejuif, France
  5. 5Marshfield Clinic Research Foundation, Marshfield, Wisconsin
  6. 6Department of Medicine, University of Western Australia, Perth, Australia
  1. Address correspondence and reprint requests to Robyn Tapp, Department of Epidemiology and Preventive Medicine, Central and Eastern Clinical School, Monash University, Alfred Hospital, Prahran, Vic 3004, Australia. E-mail: robyn.tapp{at}med.monash.edu.au

Abstract

OBJECTIVE—The aim of this work was to study the frequency of examining for diabetic eye and foot complications in an Australian population and to study factors associated with regular screening.

RESEARCH DESIGN AND METHODS—The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab) was a population-based study of 11,247 people from randomly selected areas of Australia. Participants identified as having previously diagnosed diabetes (n = 475) were invited to participate in the complications study. Measures included foot examination, retinopathy photography, and self-report use of health care services.

RESULTS—Seventy-seven percent of participants reported having an eye examination within the previous 2 years, and 50% reported having their feet examined by a health professional in the previous year. Type of diabetes treatment (odds ratio 1.46, 95% CI 0.85–2.50 for tablets versus diet alone and 4.17, 1.71–10.17 for insulin or insulin and tablets versus diet alone) and visiting a diabetes nurse educator in the previous 12 months (2.14, 1.18–3.87) were independent predictors of having had an eye examination. Duration of diabetes (1.33, 1.06–1.67 per year) and visiting a diabetes nurse educator in the previous 12 months (1.89, 1.20–2.95) were independent predictors of a foot examination.

CONCLUSIONS—This study has shown that retinopathy screening is performed more frequently than foot screening in Australia. This may be due to the implementation of eye screening programs and awareness campaigns. Foot screening appears to be poor, with less than one-half of the population reporting a regular examination for foot complications. In Australia, diabetes nurse educators play a key role in promoting screening for diabetes complications.

Footnotes

  • T.A.W. is a member on an advisory panel/standing committee/board of directors for and has received honoraria or consulting fees from Abbott Australasia, Pfizer, MSD, NovoNordisk, and Eli Lilly.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted December 1, 2003.
    • Received October 7, 2003.
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  1. doi: 10.2337/diacare.27.3.688 Diabetes Care March 2004 vol. 27 no. 3 688-693
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