Prevalence of diabetic retinopathy and diabetic macular edema in a primary care-based teleophthalmology program for American Indians and Alaskan Natives
Diabetes and its complications are more common in American Indians and Alaska Natives (AI/AN) than other US racial/ethnic populations. Prior reports of diabetic retinopathy (DR) prevalence in AI/AN are dated, and research on diabetic macular edema (DME) is limited. This study characterizes the recen...
Gespeichert in:
| Veröffentlicht in: | PloS one 2018-06, Vol.13 (6), p.e0198551 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 6 |
| container_start_page | e0198551 |
| container_title | PloS one |
| container_volume | 13 |
| creator | Bursell, Sven-Erik Fonda, Stephanie J Lewis, Drew G Horton, Mark B |
| description | Diabetes and its complications are more common in American Indians and Alaska Natives (AI/AN) than other US racial/ethnic populations. Prior reports of diabetic retinopathy (DR) prevalence in AI/AN are dated, and research on diabetic macular edema (DME) is limited. This study characterizes the recent prevalence of DR and DME in AI/AN using primary care-based teleophthalmology surveillance.
This is a multi-site, clinic-based, cross-sectional study of DR and DME. The sample is composed of AI /AN patients with diabetes (n = 53,998), served by the nationally distributed Indian Health Service-Joslin Vision Network Teleophthalmology Program (IHS-JVN) in primary care clinics of US Indian Health Service (IHS), Tribal, and Urban Indian health care facilities (I/T/U) from 1 November 2011 to 31 October 2016. Patients were recruited opportunistically for a retinal examination using the IHS-JVN during their regular diabetes care. The IHS-JVN used clinically validated, non-mydriatic, retinal imaging and retinopathy assessment protocols to identify the severity levels of non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), DME, and sight threatening retinopathy (STR; a composite measure). Key social-demographic (age, gender, IHS area), diabetes-related health (diabetes therapy, duration of diabetes, A1c), and imaging technology variables were examined. The analysis calculated frequencies and percentages of severity levels of disease.
Prevalence of any NPDR, PDR, DME, and STR among AI/AN patients undergoing DR teleophthalmology surveillance by IHS-JVN was 17.7%, 2.3%, 2.3%, and 4.2%, respectively. Prevalence was lowest in Alaska and highest among patients with A1c >/ = 8%, duration of diabetes > 10 years, or using insulin.
Prevalence of DR in this cohort was approximately half that in previous reports for AI/AN, and prevalence of DME was less than that reported in non-AI/AN populations. A similar reduction in diabetes related end-stage renal disease in the same population and time period has been reported by other researchers. Since these two diabetic complications share a common microvasculopathic mechanism, this coincident change in prevalence may also share a common basis, possibly related to improved diabetes management. |
| doi_str_mv | 10.1371/journal.pone.0198551 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2062795894</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A543719953</galeid><doaj_id>oai_doaj_org_article_33d3c20dbd724626914af1a937a6f9af</doaj_id><sourcerecordid>A543719953</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-ccde3bd0b5c8de4cd199d0976d0af1a4e6f59066641df13cec90e5fca9c146b83</originalsourceid><addsrcrecordid>eNqNk9tu1DAQhiMEolB4AwSWkBBc7GLHiXd9g7SqOKxUUcTp1prYk10Xx17spKJvwuPitGnpol4gS3E0_uaf8XimKJ4wOmd8wV6fhiF6cPNd8DinTC7rmt0pHjDJy5koKb974_-geJjSKaU1XwpxvzgopSyrZSUeFL8_RTwDh14jCS0xFhrsrSYxf33YQb89J-DN34MO9OAgEjTYAbGeANlF20E8JxoizhpIaEiPDsNu22_BdcGFzXmGwiZCR9oQyarDaDV4svZZ16eLCCsH6Ue2fYTenmF6VNxrwSV8PO2Hxbd3b78efZgdn7xfH62OZ1rIsp9pbZA3hja1XhqstGFSGioXwlBoGVQo2lpSIUTFTMu4Ri0p1q0GqVklmiU_LJ5d6u5cSGoqalIlFeVC1ktZZWJ9SZgAp2q6rApg1YUhxI2CmEvjUHFuuC6pacyirEQpJKvGLCRfgGgltFnrzRRtaDo0Gn0fwe2J7p94u1WbcKYEZbRkYzIvJ4EYfg6YetXZpNE58BiGMe96kd-YC57R5_-gt99uoja5C5T1bchx9SiqVnWVG03KetSa30LllbvA6tyBrc32PYdXew6Z6fFXv4EhJbX-8vn_2ZPv--yLG-wWwfXbFNzQ2-DTPlhdgjqGlCK210VmVI0DdFUNNQ6QmgYouz29-UDXTlcTw_8AGEcZPg</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2062795894</pqid></control><display><type>article</type><title>Prevalence of diabetic retinopathy and diabetic macular edema in a primary care-based teleophthalmology program for American Indians and Alaskan Natives</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><source>Public Library of Science (PLoS)</source><creator>Bursell, Sven-Erik ; Fonda, Stephanie J ; Lewis, Drew G ; Horton, Mark B</creator><creatorcontrib>Bursell, Sven-Erik ; Fonda, Stephanie J ; Lewis, Drew G ; Horton, Mark B</creatorcontrib><description>Diabetes and its complications are more common in American Indians and Alaska Natives (AI/AN) than other US racial/ethnic populations. Prior reports of diabetic retinopathy (DR) prevalence in AI/AN are dated, and research on diabetic macular edema (DME) is limited. This study characterizes the recent prevalence of DR and DME in AI/AN using primary care-based teleophthalmology surveillance.
This is a multi-site, clinic-based, cross-sectional study of DR and DME. The sample is composed of AI /AN patients with diabetes (n = 53,998), served by the nationally distributed Indian Health Service-Joslin Vision Network Teleophthalmology Program (IHS-JVN) in primary care clinics of US Indian Health Service (IHS), Tribal, and Urban Indian health care facilities (I/T/U) from 1 November 2011 to 31 October 2016. Patients were recruited opportunistically for a retinal examination using the IHS-JVN during their regular diabetes care. The IHS-JVN used clinically validated, non-mydriatic, retinal imaging and retinopathy assessment protocols to identify the severity levels of non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), DME, and sight threatening retinopathy (STR; a composite measure). Key social-demographic (age, gender, IHS area), diabetes-related health (diabetes therapy, duration of diabetes, A1c), and imaging technology variables were examined. The analysis calculated frequencies and percentages of severity levels of disease.
Prevalence of any NPDR, PDR, DME, and STR among AI/AN patients undergoing DR teleophthalmology surveillance by IHS-JVN was 17.7%, 2.3%, 2.3%, and 4.2%, respectively. Prevalence was lowest in Alaska and highest among patients with A1c >/ = 8%, duration of diabetes > 10 years, or using insulin.
Prevalence of DR in this cohort was approximately half that in previous reports for AI/AN, and prevalence of DME was less than that reported in non-AI/AN populations. A similar reduction in diabetes related end-stage renal disease in the same population and time period has been reported by other researchers. Since these two diabetic complications share a common microvasculopathic mechanism, this coincident change in prevalence may also share a common basis, possibly related to improved diabetes management.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0198551</identifier><identifier>PMID: 29924846</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Age Factors ; Aged ; Alaska Natives ; American Indians ; Biology and Life Sciences ; Chi-square test ; Chronic kidney failure ; Complications ; Data analysis ; Demographics ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - ethnology ; Diabetic retinopathy ; Diabetic Retinopathy - epidemiology ; Diabetic Retinopathy - ethnology ; Edema ; End-stage renal disease ; Female ; Fundus Oculi ; Genetic Predisposition to Disease ; Glycated Hemoglobin - analysis ; Health care ; Health services ; Humans ; Indians, North American ; Insulin ; Kidney diseases ; Lasers ; Lewis, Mark ; Macular Edema - epidemiology ; Macular Edema - ethnology ; Male ; Medical imaging ; Medicine and Health Sciences ; Middle Aged ; Native Americans ; Native North Americans ; Ophthalmology - organization & administration ; Ophthalmoscopy - methods ; Patients ; People and places ; Photography - methods ; Physical Sciences ; Population Surveillance ; Populations ; Prevalence ; Primary care ; Primary Health Care - organization & administration ; Protocol (computers) ; Research and Analysis Methods ; Retina ; Retinal images ; Retinopathy ; Retrospective Studies ; Selection Bias ; Studies ; Surveillance ; Systematic review ; Telemedicine ; Telemedicine - organization & administration ; United States - epidemiology</subject><ispartof>PloS one, 2018-06, Vol.13 (6), p.e0198551</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-ccde3bd0b5c8de4cd199d0976d0af1a4e6f59066641df13cec90e5fca9c146b83</citedby><cites>FETCH-LOGICAL-c692t-ccde3bd0b5c8de4cd199d0976d0af1a4e6f59066641df13cec90e5fca9c146b83</cites><orcidid>0000-0003-4902-5455</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010214/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010214/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29924846$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bursell, Sven-Erik</creatorcontrib><creatorcontrib>Fonda, Stephanie J</creatorcontrib><creatorcontrib>Lewis, Drew G</creatorcontrib><creatorcontrib>Horton, Mark B</creatorcontrib><title>Prevalence of diabetic retinopathy and diabetic macular edema in a primary care-based teleophthalmology program for American Indians and Alaskan Natives</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Diabetes and its complications are more common in American Indians and Alaska Natives (AI/AN) than other US racial/ethnic populations. Prior reports of diabetic retinopathy (DR) prevalence in AI/AN are dated, and research on diabetic macular edema (DME) is limited. This study characterizes the recent prevalence of DR and DME in AI/AN using primary care-based teleophthalmology surveillance.
This is a multi-site, clinic-based, cross-sectional study of DR and DME. The sample is composed of AI /AN patients with diabetes (n = 53,998), served by the nationally distributed Indian Health Service-Joslin Vision Network Teleophthalmology Program (IHS-JVN) in primary care clinics of US Indian Health Service (IHS), Tribal, and Urban Indian health care facilities (I/T/U) from 1 November 2011 to 31 October 2016. Patients were recruited opportunistically for a retinal examination using the IHS-JVN during their regular diabetes care. The IHS-JVN used clinically validated, non-mydriatic, retinal imaging and retinopathy assessment protocols to identify the severity levels of non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), DME, and sight threatening retinopathy (STR; a composite measure). Key social-demographic (age, gender, IHS area), diabetes-related health (diabetes therapy, duration of diabetes, A1c), and imaging technology variables were examined. The analysis calculated frequencies and percentages of severity levels of disease.
Prevalence of any NPDR, PDR, DME, and STR among AI/AN patients undergoing DR teleophthalmology surveillance by IHS-JVN was 17.7%, 2.3%, 2.3%, and 4.2%, respectively. Prevalence was lowest in Alaska and highest among patients with A1c >/ = 8%, duration of diabetes > 10 years, or using insulin.
Prevalence of DR in this cohort was approximately half that in previous reports for AI/AN, and prevalence of DME was less than that reported in non-AI/AN populations. A similar reduction in diabetes related end-stage renal disease in the same population and time period has been reported by other researchers. Since these two diabetic complications share a common microvasculopathic mechanism, this coincident change in prevalence may also share a common basis, possibly related to improved diabetes management.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Alaska Natives</subject><subject>American Indians</subject><subject>Biology and Life Sciences</subject><subject>Chi-square test</subject><subject>Chronic kidney failure</subject><subject>Complications</subject><subject>Data analysis</subject><subject>Demographics</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - ethnology</subject><subject>Diabetic retinopathy</subject><subject>Diabetic Retinopathy - epidemiology</subject><subject>Diabetic Retinopathy - ethnology</subject><subject>Edema</subject><subject>End-stage renal disease</subject><subject>Female</subject><subject>Fundus Oculi</subject><subject>Genetic Predisposition to Disease</subject><subject>Glycated Hemoglobin - analysis</subject><subject>Health care</subject><subject>Health services</subject><subject>Humans</subject><subject>Indians, North American</subject><subject>Insulin</subject><subject>Kidney diseases</subject><subject>Lasers</subject><subject>Lewis, Mark</subject><subject>Macular Edema - epidemiology</subject><subject>Macular Edema - ethnology</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Native Americans</subject><subject>Native North Americans</subject><subject>Ophthalmology - organization & administration</subject><subject>Ophthalmoscopy - methods</subject><subject>Patients</subject><subject>People and places</subject><subject>Photography - methods</subject><subject>Physical Sciences</subject><subject>Population Surveillance</subject><subject>Populations</subject><subject>Prevalence</subject><subject>Primary care</subject><subject>Primary Health Care - organization & administration</subject><subject>Protocol (computers)</subject><subject>Research and Analysis Methods</subject><subject>Retina</subject><subject>Retinal images</subject><subject>Retinopathy</subject><subject>Retrospective Studies</subject><subject>Selection Bias</subject><subject>Studies</subject><subject>Surveillance</subject><subject>Systematic review</subject><subject>Telemedicine</subject><subject>Telemedicine - organization & administration</subject><subject>United States - epidemiology</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9tu1DAQhiMEolB4AwSWkBBc7GLHiXd9g7SqOKxUUcTp1prYk10Xx17spKJvwuPitGnpol4gS3E0_uaf8XimKJ4wOmd8wV6fhiF6cPNd8DinTC7rmt0pHjDJy5koKb974_-geJjSKaU1XwpxvzgopSyrZSUeFL8_RTwDh14jCS0xFhrsrSYxf33YQb89J-DN34MO9OAgEjTYAbGeANlF20E8JxoizhpIaEiPDsNu22_BdcGFzXmGwiZCR9oQyarDaDV4svZZ16eLCCsH6Ue2fYTenmF6VNxrwSV8PO2Hxbd3b78efZgdn7xfH62OZ1rIsp9pbZA3hja1XhqstGFSGioXwlBoGVQo2lpSIUTFTMu4Ri0p1q0GqVklmiU_LJ5d6u5cSGoqalIlFeVC1ktZZWJ9SZgAp2q6rApg1YUhxI2CmEvjUHFuuC6pacyirEQpJKvGLCRfgGgltFnrzRRtaDo0Gn0fwe2J7p94u1WbcKYEZbRkYzIvJ4EYfg6YetXZpNE58BiGMe96kd-YC57R5_-gt99uoja5C5T1bchx9SiqVnWVG03KetSa30LllbvA6tyBrc32PYdXew6Z6fFXv4EhJbX-8vn_2ZPv--yLG-wWwfXbFNzQ2-DTPlhdgjqGlCK210VmVI0DdFUNNQ6QmgYouz29-UDXTlcTw_8AGEcZPg</recordid><startdate>20180620</startdate><enddate>20180620</enddate><creator>Bursell, Sven-Erik</creator><creator>Fonda, Stephanie J</creator><creator>Lewis, Drew G</creator><creator>Horton, Mark B</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-4902-5455</orcidid></search><sort><creationdate>20180620</creationdate><title>Prevalence of diabetic retinopathy and diabetic macular edema in a primary care-based teleophthalmology program for American Indians and Alaskan Natives</title><author>Bursell, Sven-Erik ; Fonda, Stephanie J ; Lewis, Drew G ; Horton, Mark B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-ccde3bd0b5c8de4cd199d0976d0af1a4e6f59066641df13cec90e5fca9c146b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Alaska Natives</topic><topic>American Indians</topic><topic>Biology and Life Sciences</topic><topic>Chi-square test</topic><topic>Chronic kidney failure</topic><topic>Complications</topic><topic>Data analysis</topic><topic>Demographics</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - ethnology</topic><topic>Diabetic retinopathy</topic><topic>Diabetic Retinopathy - epidemiology</topic><topic>Diabetic Retinopathy - ethnology</topic><topic>Edema</topic><topic>End-stage renal disease</topic><topic>Female</topic><topic>Fundus Oculi</topic><topic>Genetic Predisposition to Disease</topic><topic>Glycated Hemoglobin - analysis</topic><topic>Health care</topic><topic>Health services</topic><topic>Humans</topic><topic>Indians, North American</topic><topic>Insulin</topic><topic>Kidney diseases</topic><topic>Lasers</topic><topic>Lewis, Mark</topic><topic>Macular Edema - epidemiology</topic><topic>Macular Edema - ethnology</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Native Americans</topic><topic>Native North Americans</topic><topic>Ophthalmology - organization & administration</topic><topic>Ophthalmoscopy - methods</topic><topic>Patients</topic><topic>People and places</topic><topic>Photography - methods</topic><topic>Physical Sciences</topic><topic>Population Surveillance</topic><topic>Populations</topic><topic>Prevalence</topic><topic>Primary care</topic><topic>Primary Health Care - organization & administration</topic><topic>Protocol (computers)</topic><topic>Research and Analysis Methods</topic><topic>Retina</topic><topic>Retinal images</topic><topic>Retinopathy</topic><topic>Retrospective Studies</topic><topic>Selection Bias</topic><topic>Studies</topic><topic>Surveillance</topic><topic>Systematic review</topic><topic>Telemedicine</topic><topic>Telemedicine - organization & administration</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bursell, Sven-Erik</creatorcontrib><creatorcontrib>Fonda, Stephanie J</creatorcontrib><creatorcontrib>Lewis, Drew G</creatorcontrib><creatorcontrib>Horton, Mark B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bursell, Sven-Erik</au><au>Fonda, Stephanie J</au><au>Lewis, Drew G</au><au>Horton, Mark B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of diabetic retinopathy and diabetic macular edema in a primary care-based teleophthalmology program for American Indians and Alaskan Natives</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-06-20</date><risdate>2018</risdate><volume>13</volume><issue>6</issue><spage>e0198551</spage><pages>e0198551-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Diabetes and its complications are more common in American Indians and Alaska Natives (AI/AN) than other US racial/ethnic populations. Prior reports of diabetic retinopathy (DR) prevalence in AI/AN are dated, and research on diabetic macular edema (DME) is limited. This study characterizes the recent prevalence of DR and DME in AI/AN using primary care-based teleophthalmology surveillance.
This is a multi-site, clinic-based, cross-sectional study of DR and DME. The sample is composed of AI /AN patients with diabetes (n = 53,998), served by the nationally distributed Indian Health Service-Joslin Vision Network Teleophthalmology Program (IHS-JVN) in primary care clinics of US Indian Health Service (IHS), Tribal, and Urban Indian health care facilities (I/T/U) from 1 November 2011 to 31 October 2016. Patients were recruited opportunistically for a retinal examination using the IHS-JVN during their regular diabetes care. The IHS-JVN used clinically validated, non-mydriatic, retinal imaging and retinopathy assessment protocols to identify the severity levels of non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), DME, and sight threatening retinopathy (STR; a composite measure). Key social-demographic (age, gender, IHS area), diabetes-related health (diabetes therapy, duration of diabetes, A1c), and imaging technology variables were examined. The analysis calculated frequencies and percentages of severity levels of disease.
Prevalence of any NPDR, PDR, DME, and STR among AI/AN patients undergoing DR teleophthalmology surveillance by IHS-JVN was 17.7%, 2.3%, 2.3%, and 4.2%, respectively. Prevalence was lowest in Alaska and highest among patients with A1c >/ = 8%, duration of diabetes > 10 years, or using insulin.
Prevalence of DR in this cohort was approximately half that in previous reports for AI/AN, and prevalence of DME was less than that reported in non-AI/AN populations. A similar reduction in diabetes related end-stage renal disease in the same population and time period has been reported by other researchers. Since these two diabetic complications share a common microvasculopathic mechanism, this coincident change in prevalence may also share a common basis, possibly related to improved diabetes management.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29924846</pmid><doi>10.1371/journal.pone.0198551</doi><tpages>e0198551</tpages><orcidid>https://orcid.org/0000-0003-4902-5455</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2018-06, Vol.13 (6), p.e0198551 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2062795894 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Age Factors Aged Alaska Natives American Indians Biology and Life Sciences Chi-square test Chronic kidney failure Complications Data analysis Demographics Diabetes Diabetes mellitus Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - ethnology Diabetic retinopathy Diabetic Retinopathy - epidemiology Diabetic Retinopathy - ethnology Edema End-stage renal disease Female Fundus Oculi Genetic Predisposition to Disease Glycated Hemoglobin - analysis Health care Health services Humans Indians, North American Insulin Kidney diseases Lasers Lewis, Mark Macular Edema - epidemiology Macular Edema - ethnology Male Medical imaging Medicine and Health Sciences Middle Aged Native Americans Native North Americans Ophthalmology - organization & administration Ophthalmoscopy - methods Patients People and places Photography - methods Physical Sciences Population Surveillance Populations Prevalence Primary care Primary Health Care - organization & administration Protocol (computers) Research and Analysis Methods Retina Retinal images Retinopathy Retrospective Studies Selection Bias Studies Surveillance Systematic review Telemedicine Telemedicine - organization & administration United States - epidemiology |
| title | Prevalence of diabetic retinopathy and diabetic macular edema in a primary care-based teleophthalmology program for American Indians and Alaskan Natives |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T02%3A12%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence%20of%20diabetic%20retinopathy%20and%20diabetic%20macular%20edema%20in%20a%20primary%20care-based%20teleophthalmology%20program%20for%20American%20Indians%20and%20Alaskan%20Natives&rft.jtitle=PloS%20one&rft.au=Bursell,%20Sven-Erik&rft.date=2018-06-20&rft.volume=13&rft.issue=6&rft.spage=e0198551&rft.pages=e0198551-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0198551&rft_dat=%3Cgale_plos_%3EA543719953%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2062795894&rft_id=info:pmid/29924846&rft_galeid=A543719953&rft_doaj_id=oai_doaj_org_article_33d3c20dbd724626914af1a937a6f9af&rfr_iscdi=true |