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Diabetic Retinopathy module for RAAB 5

Diabetic Retinopathy module for RAAB 5. David Yorston Sarah Polack Hannah Kuper Hans Limburg. Why assess DR in RAAB?. Diabetes – a growing problem. Source: International Diabetes Foundation, 2011. Diabetic retinopathy. Other 11%. Trachoma 3%. Cataract 39%. Childhood 3%. DR 4%. CO 4%.

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Diabetic Retinopathy module for RAAB 5

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  1. Diabetic Retinopathy module for RAAB 5 David Yorston Sarah Polack Hannah Kuper Hans Limburg

  2. Why assess DR in RAAB?

  3. Diabetes – a growing problem Source: International Diabetes Foundation, 2011

  4. Diabetic retinopathy Other 11% Trachoma 3% Cataract 39% Childhood 3% DR 4% CO 4% ARMD 7% Glaucoma 10% Refractive error 18%

  5. Few countries with population based DR prevalence data

  6. What this will tell us DR module provides estimates of: • Prevalence of diabetes • Prevalence of DR and sight threatening DR in people with diabetes and in general population • Coverage of DR examinations among people with known diabetes • Levels of glycaemic control among people with diabetes ….among people aged 50+ years ….to be used to inform service planning

  7. Results from Chiapas, Mexico

  8. Methods

  9. 1. Obtain informed written consent • Explain (participant information sheet): • Purpose of study • Procedures involved • Risks (affect of dilation on vision) • Participation is voluntary • Confidentiality • Consenting participants must sign/thumb-print consent form • To be done when first arrive at the household

  10. 2. Assess diabetes (section H) Diabetes: Previous diagnosis and/or RBG ≥200mg/dl • Ask about previous diagnosis • Test random blood glucose Known diabetes: Previous diagnosis (regardless of current RBG) Newly diagnosed diabetes: No previous diagnosis, but RBG ≥200mg/dl

  11. 3. Ask questions to people with known diabetes (section I) • Age of diagnosis • Diabetes treatment • Diabetic eye exam

  12. 4. Dilated eye examination of all people with diabetes (section J) Dilated examination with direct & indirect ophthalmoscope

  13. Diabetes classification

  14. Obtain informed consent Standard RAAB protocol Diabetes assessment Known ‘diabetes’ Newly diagnosed ‘diabetes’ No ‘diabetes’ Finish! Ask questions about diabetes Dilate pupils Fundus examination

  15. However! • Standard RAAB: • 4-5 days training; cost 20-40,000 US$ • RAAB + DR • 5-7 days training; cost 40-100,000 US$ • Prevalence of diabetes >20% in people 50+ • 1 team: 35 persons/day; 2 teams 60/day • Requires DR specialists and equipment • Special trainer for DR

  16. Downloads of RAAB 5will soon be available at:www.ICEH.orgThank you!

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