Integrating microvascular assessments into one clinic, in an annual one-stop approach

Abstract

Background: Uncontrolled diabetes can cause many microvascular complications. Thus, early detection and appropriate treatment are essential to prevent diabetes complications that may cause disability and death. The main aim of the study is to test the effectiveness of a one stop screening clinic for retinopathy, nephropathy, and neuropathy for people with diabetes. Methods : A cross-sectional observational study, the study was done during a period of 3 months from February to March 2019. We used convenience sampling to select participants who attended the screening clinic of the Diabetes Care Center at King Salman Hospital, Riyadh, Saudi Arabia. A total of 260 diabetic patients participated in the study. Results: The study included 260 participants, around 61% were female participants. The mean age of the participants was 51 years. Most of the participants were type 2 diabetic patients (93.5%). Patients’ acceptance and satisfaction rates of the one stop clinic were 100%. Non-proliferative diabetic retinopathy prevalence was 11%. Meanwhile, the prevalence of maculopathy was 1.5%. The prevalence of micro-albuminuria was 18.6% and macro-albuminuria was 1.9%. Also, the prevalence of chronic kidney disease stage 3 was 4.2% and stage 4 was 0.4%. We found that neuropathic symptoms were present in 40.7% of the participants. The prevalence of diabetic peripheral neuropathy (DNP) according to the neuropathy disability score, which is our gold standard test was 13.8% and using 10-g monofilament test was 19.5%. Meanwhile, the prevalence of DNP according to DPN-check was 40.9%, and according to Sudoscan was 73%. Conclusion: Having one clinic that combines retinopathy, nephropathy, and neuropathy screening is possible. A one stop clinic is also highly accepted, reduces clinical visits, and can detect microvascular disease.