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Friday, 15 January 2016

Diabetics do you want to know your complication risk?

Researchers in the United Kingdom have developed a validated risk assessment equation to show the 10-year risk of blindness and lower limb amputation in diabetes patients. Such tools have already been developed for the general population to assess heart attack, stroke and diabetes risk, and now the QDiabetes tool is the first tool for diabetics that gives an accurate assessment of their risk of these most feared complications.

Data has been collected from English General Practitioners since 1998 from over 400,000 patients. The algorithms are based on variables that patients are likely to know or that can be found from asking your GP. Knowing your risk could be worthwhile so you would know to intensify your control and monitor your condition more stringently.

For clinicians, complication risk could enable screening programs to be tailored to an individual’s need for support and the more rational use of scarce resources. Retinopathy could be done more frequently than once a year for those who need it and less frequently than once a year for those who do not. Those at higher risk of amputation might benefit from a proactive targeted program to prevent lower extremity amputation (including more frequent checks, tailored patient education, specially designed protective footwear, and early reporting of foot injuries), as this has been shown to substantially reduce the risk of emergency admissions, use of antibiotics, foot operations, and lower limb amputation compared with usual practice.

My results click on screenshot to enlarge. 

I found this diabetes complication calculator at the excellent site co run by Dr. Katharine Morrison which can be found here. How accurate this tool is, is open to debate, but if it is a good indicator for future complications, as a type two diabetic I would be happy with the results it gave me. Let's face it, all diabetics have a higher risk of complications, but we can drastically improve our chances of not succumbing to serious complications by holding excellent blood glucose numbers.

One problem with the calculator is the fact the minimum HbA1c you can enter is 40, mine is lower than that, as is many other diabetics I know. As you would expect, all of these people are low carbers. Perhaps the people that designed this tool thought no diabetics ever hold numbers better than 40. Maybe by inserting my lower than 40 HbA1c my results would have been better, who knows.

The future risk of complications calculator can be found here.


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