Ibanez-Bruron, Maria C;
(2019)
Epidemiology and pathways of care of diabetic eye disease in children and young people in the UK: The Diabetic Eye disease in Childhood Study (DECS).
Doctoral thesis (Ph.D), UCL (University College London).
Abstract
Background: In the UK, more children and young people (CYP) than ever are at risk of visual loss due to the increasing prevalence of diabetes. Information on their processes and outcomes is lacking. The Diabetic Eye disease in Childhood Study (DECS) aimed to provide relevant, currently unknown, data so as to inform policy and practice. / Methods: Complementary approaches were used to collect information. Data on the burden of diabetic eye disease were collected through a systematic review, a UK active surveillance of incident sight-threatening diabetic eye diseases in CYP, and an analysis of data routinely-collected by Diabetic Eye Screening Programmes (DESPs) across England. DESP datasets were also used to examine patterns of screening uptake. Finally, communication between paediatric diabetes units (PDUs) and DESPs were investigated through two national surveys of practice in England. / Results: The incidence of sight-threatening eye disease was extremely low in the UK, with cataract being more common than diabetic retinopathy (DR). Prevalence of background DR (the mildest stage) was, however, common (21%) in those aged 18 years or under based on DESPs data. Background DR (BDR) was the strongest predictor of sight-threatening DR (STDR). Although overall screening uptake was high, there were differences by age and socio-economic deprivation. The ‘map’ of communication between PDUs and DESPs revealed some disconnection between these services, which was also observed in the rationale behind the utility of retinal examinations of CYP. Periodic retinal examination is considered as both clinical surveillance for the occurrence of BDR, and screening for the progression from BDR to STDR. / Conclusions: Improving the care of CYP necessitates better integration, communication and clarity of purpose between already organised, but separated, programmes, specifically the paediatric diabetes care and diabetic eye screening programmes.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Epidemiology and pathways of care of diabetic eye disease in children and young people in the UK: The Diabetic Eye disease in Childhood Study (DECS) |
| Event: | UCL (University College London) |
| Language: | English |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10071947 |
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