OBJECTIVES

: Diabetic retinopathy (DR) is one of the leading causes of vision impairment world-wide. A sizable portion of DR patients will develop complete blindness that severely impacts their quality of life. Early detection and intervention are vital to prevent and slow DR progression. This large scale real world evidence (RWE) generation initiative is designed to enable longitudinal comparison and assessment of the clinical and economic effectiveness of different diabetes management approaches, under the community healthcare delivery setting in China.

METHODS

: This ongoing public-private collaboration uses a portable Fundus fluorescein angiography device to perform DR screening at the community level in China. Diabetes patients complete the DR screening at community health centers. Due to the lack of specialist physicians and facilities available at these community hospitals, images are remotely evaluated by expert physicians at better equipped locations. Based on the diagnosis, patients are referred to specialists for treatment and more frequent follow up, or scheduled for routine screening every six months. Data regarding patients test results and diabetes treatment is downloaded from medical records at the time of screening. This screening, which began in December 2017, will cover 58,400 patients by the end of 2018.

RESULTS

: Data was analyzed from 800 patients who were screened in the first month of the program. 14.5% of the type 2 diabetes patients screened were diagnosed with DR, with 3.6% of these patients having already reached the proliferative stage. 55% of patients exceeded fasting plasma glucose (FPG) standard levels and 80% exceeded HbA1c standard levels. 90.5% of patients had pre-hypertension or hypertension.

CONCLUSIONS

: This initial DR screening dataset demonstrates the urgent need to improve diabetes management in China at the grass root community level. The data collected in the DR screening program will provide valuable real-world evidence to improve diabetes care in China.