Complications of diabetes: screening for retinopathy; management of foot ulcers

NHS Centre for Reviews and Dissemination
Record ID 31999009322
Authors' objectives:

This bulletin is based on two systematic reviews undertake to inform National Clinical Practice Guidelines for Type 2 diabetes. The report is divided into two main sections, the first dealing with screening for diabetic retinopathy and the second with prevention and treatment of diabetic foot ulcers.

Authors' recommendations: Over a million people in the United Kingdom have diabetes, of which the majority have Type 2 (non-insulin dependent) diabetes. Diabetic retinopathy is the most common cause of blindness in people of working age in industrialised countries. Up to 40% of people have some retinopathy when Type 2 diabetes is first diagnosed. In its early stages, retinopathy causes no symptoms, but it can be detected by examination of the back of the eye. It has been estimated that comprehensive screening and treatment for diabetic retinopathy could prevent 260 new cases of blindness every year. Screening can be effectively provided by trained and accredited optometrists or by retinal photographers in a variety of locations. Screening needs to be efficiently organised at a local level to ensure adequate population coverage. 15% of people with diabetes develop foot ulcers associated with nerve damage (neuropathy), lack of blood supply (ischaemia), or both. Serious infection originating in a diabetic ulcer is the most common reason for amputation apart from trauma. Multidisciplinary interventions, such as education to increase patients' knowledge about foot care, podiatry, and therapeutic shoes, can improve the condition of the feet and help to reduce ulcer and amputation rates. Various treatments are used for diabetic foot ulcers, but evidence for their effectiveness is generally poor.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 1999
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Costs and Cost Analysis
  • Diabetes Mellitus
  • Diabetic Foot
  • Diabetic Retinopathy
  • Mass Screening
Organisation Name: University of York
Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,
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Copyright: Centre for Reviews and Dissemination
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.