Abstract

DO.13.07

The HbA1c level as a key parameter in the interdisciplinary cooperation between ophthalmologist and diabetologist in patients with diabetic retinopathy

Henschel A., Trieschmann M., Pauleikhoff D., Spital G.
Department of Ophthalmology, Franziskus Hospital Münster

Objective: The effective medical therapy of diabetes mellitus is the basis of success of ophthalmologic therapy in patients with diabetic retinopathy. An assessment of the patient’s metabolic situation solely based on interview poses several uncertainties to the ophtalmologist. Especially incompliant patients often cannot provide sufficient information on the control of their blood glucose levels. These patients are most likely to develop eye complications. A laboratory parameter like the HbA1c allows a more valid assessment of medium-term control over blood glucose levels.
Methods: In our department, on-site HbA1c measurement was performed in every diabetic patient unaware of his HbA1c level, and whenever the latest level had been determined more than six weeks earlier. A standardized interview regarding the history and complications of the diabetic disease was performed additionally.
Results: To this date, the described practice was performed in 131 patients. 52% of patients didn’t know their HbA1c value. In 21% of cases the measured HbA1c value was higher than the value provided by the patient in the interview. HbA1c value an overall length of diabetic disease correlated with the severity of diabetic retinopathy. Nine patients with very high Hba1c levels (mean 11,5%) were directly transferred to a cooperating diabetologic specialist.
Conclusions: HbA1c is an easy and inexpensively obtainable laboratory parameter which can provide a good estimate of a patients’ medium-term blood glucose levels. The ophthalmologist can use it as a key parameter to identify patients who need an optimization of their medical diabetes therapy and can transfer these patients to a specialist accordingly. The knowledge of the patients’ quality of blood glucose control can be useful to estimate the long-term prognosis of diabetic retinopathy and the prospects of success of any ophthalmologic therapy for diabetic retinopathy.

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