糖尿病患者的微血管并发症详解演示文稿.pptVIP

Key Points The UKPDS also looked at the influence of blood pressure control in 1148 subjects randomized to tight blood pressure control (target BP 150/85 mmHg) over less tight (target BP 180/105 mmHg). The BP achieved, tight versus less tight: 144/82 vs 154/87 mmHg. Subjects randomized to tight BP control showed a 34% reduction in progression of retinopathy and a 47% reduction in the risk of deterioration in their visual acuity. Key Points What about the role of aspirin as a treatment modality? The Early Treatment Diabetic Retinopathy Study (ETDRS) investigated whether aspirin at 650 mg/day could slow the progression of retinopathy, but it was shown to have no effect. Key Points Screening is a key issue. For patients with type 1 diabetes, screening should be done within the first 3-5 years of diagnosis. In type 2, because of the probability that retinopathy already exists at time of diagnosis, screening should be done immediately. Women with pre-existing diabetes should be screened prior to conception and during their first trimester. Follow-up screening should be done annually, more often if abnormalities are detected, and less frequently (every 2-3 years) if one or more eye exams is normal. American Diabetes Association. Executive Summary: Standards of Medical Care in Diabetes—2009. Diabetes Care 2009;32(Suppl 1):S6-S12. Key Points Screening for retinopathy is always justified because it is an important health problem with a known natural history. When we detect it early, we can effectively treat it. And screening is simple to perform, acceptable to patients and cost-effective. Key Points Several types of professionals can screen for retinopathy. It is generally preferred that it be done by ophthalmologists, optometrists or retinal imaging/photography services – but with proper training, it can also be done by diabetologists, endocrinologists, clinicians in hospital-based diabetes centres, and GPs. Key Point Let’s talk about the role of fundo