Research carried out at the Peninsula College of Medicine and Dentistry (PCMD), University of Exeter, has concluded that it would be a safe and cost-effective strategy to screen people with type 2 diabetes who have not yet developed diabetic retinopathy, for the disease once every two years instead of annually.
The research is supported by funding from the National Institute for Health Research Peninsula Collaboration for Leadership in Applied Health Research and Care (NIHR PenCLAHRC). It is published today (00:01hrs BST Monday 7th May 2012) on-line in Diabetes Care.
Diabetic retinopathy is a common complication of diabetes. It occurs when high blood sugar levels damage the cells in the retina and, if not treated, can lead to blindness. In all but some cases diabetic retinopathy has a typically slow rate of progression and can take years to develop.
The research team developed a model that simulated the progression of retinopathy in type 2 diabetes and related screening, in order to predict the rates of retinopathy-related sight loss. The model used data from the Royal Devon & Exeter NHS Foundation Trust in the South West of the UK and the research team generated comparative 15-year forecasts to assess the differences between current screening policies and those proposed by the findings of the study.
The study concluded that it is safe to screen type 2 diabetes patients who have not been diagnosed with retinopathy every two years rather than annually, because the research team found that the proportion of patients who develop retinopathy-related sight loss was no different between the two screening intervals.
Proposed savings for the Royal Devon & Exeter Hospital, for which 3,537 of the patients it screens for retinopathy fell into the remit of this study, would be a reduction in costs from £1.83m a year to £1.36m. The study predicts savings of around 25 per cent based on standard assumptions of screening costs.
According to Diabetes UK, some 2.8m people in the UK have diabetes and 10 per cent of them are diagnosed with retinopathy.
The UK's National Institute for Clinical Excellence introduced guidelines for annual screening, but admits that this frequency is arbitrary and has welcomed research to investigate appropriate intervals between screening appointments.
The study was led by Dr. Daniel Chalk, Associate Research Fellow in Applied Operational Research, Peninsula Collaboration for Health, Operational Research and Development (PenCHORD), PCMD. He said: "This is not the first study to investigate screening for diabetic retinopathy, but it is the first to focus on the group of type 2 diabetics who have not yet been diagnosed for the condition. Diabetic retinopathy typically develops at a very slow pace, and as a consequence we wanted to identify whether or not there was any merit in reducing the frequency of screening from annually to every two years."
He added: "We found that there was no perceivable difference in the effectiveness of screening annually or every two years for this particular patient cohort, which would suggest that it would be safe and cost-effective to increase the screening interval to two years. In order to support this, an effective recall system and campaign to impress upon patients the continuing importance of such screening would be beneficial – a lengthening of the screening interval in no way undermines the validity of the screening process itself."
Notes to Editors
The Peninsula Medical School is a joint entity of the University of Exeter, the University of Plymouth and the NHS in the South West of England, and a partner of the Combined Universities in Cornwall. The Peninsula Medical School has created for itself an excellent national and international reputation for groundbreaking research in the areas of diabetes and obesity, neurological disease, child development and ageing, clinical education, health and the environment and health technology assessment. The Peninsula Medical School is licensed under the Human Tissue Act to hold ethically acquired human tissue.
NIHR- PenCLAHRC aims to bring together local universities and their surrounding NHS organisations to test new treatments and new ways of working in specific clinical areas, to see if they are effective and appropriate for everyday use in the health service. Where potential improvements are identified, PenCLAHRC helps NHS staff to incorporate them into their everyday working practices, so that patients across the local community receive a better standard of healthcare.
The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The National Institute for Health Research provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. http://www.nihr.ac.uk/
Andrew Gould | EurekAlert!
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester
Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.
As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...
16.08.2017 | Event News
04.08.2017 | Event News
26.07.2017 | Event News
22.08.2017 | Health and Medicine
22.08.2017 | Materials Sciences
22.08.2017 | Life Sciences