Retinal screening of patients with cystic fibrosis-related diabetes in Wales -- a real eye opener

Abstract

Background: The National Screening Committee recommends annual retinal screening for all diabetic patients over the age of twelve years. Currently, patients on insulin therapy for Cystic Fibrosis-Related Diabetes Mellitus (CFRD) at the All Wales Adult Cystic Fibrosis Service, UK are invited for annual screening.

Methods: Age, sex, FEV(1)%, BMI, HbA1c, duration of diabetes, duration of insulin therapy, presence of retinopathy and attendance at retinal screening in 2012 were examined for patients on insulin therapy for CFRD.

Results: 67 of the 228 (29%) patients attending the CF centre were receiving insulin therapy. 24 of the 67 (36%) did not attend retinal screening in 2012. Of the 43 who had retinal scans, 18 (42%) had evidence of retinopathy. Patients with retinopathy had a higher mean HbA1c (p=0.04), mean duration of diabetes and mean duration on insulin (p<0.001).

Conclusions: Almost half of the patients screened had evidence of retinopathy but over a third of the patients with CFRD did not attend screening appointments. Improving patient uptake of retinal scans will become increasingly important in an ageing CF population.

Keywords: Cystic fibrosis; Cystic fibrosis-related diabetes mellitus; Retinopathy; Screening.