General physicians role in stalling the progression of diabetic nephropathy and retinopathy

Introduction: The number of diabetic patients is ever increasing worldwide and it reaches epidemic proportions. General physicians (GPs) may have a significant impact on early detection and risk factors control, the issues which may lead to microvascular complications. Objective: Establish the incidence of diabetic nephropathy and retinopathy and review the measures GPs undertook to stop the further microvascular complications advance (but not the ones related to glucose measurement). Method: The research was performed as a cross-sectional study in November 2017, on 100 patients in the Counseling center for diabetes, Primary Health care Center, Zemun. Data were taken from the patients' diabetic medical charts and reviewed. They were taken at the patient's first visit, before a physician's intervention. Descriptive and analytical statistics were used for data processing. Results: Diabetic nephropathy was found in 15% of the participants and retinopathy in 14.5%. Out of 100 participants, 3 were sent to a nephrologist. Out of these 3, 2 had proteinuria. For the sake of retinopathy screening, 69 patients were referred to an ophthalmologist. Among them, retinopathy was found in 10. GPs started ACEIs (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin receptor blockers) in 73.3% of patients with proteinuria and 64.7% without proteinuria. Conclusions: The incidence of diabetic nephropathy was 15% and diabetic retinopathy 14.5%, in our research. GPs referred 69% of the patients to an ophthalmologist for retinopathy screening and started ACEI/ARB in more than 73.3% of the participants with diabetic nephropathy. Small percent was referred to a nephrologist.