A case of Non – Insulin dependent diabetes mellitus {NIDDM} with a history of diabetes for one year should have an ophthalmic examination?
## **Core Concept**
The core concept here revolves around the management and follow-up of patients with Non-Insulin Dependent Diabetes Mellitus (NIDDM), also known as Type 2 Diabetes Mellitus. Diabetic retinopathy is a common complication of diabetes that can lead to blindness if not detected and treated early. The American Diabetes Association (ADA) and other guidelines provide recommendations on the frequency of ophthalmic examinations for patients with diabetes.
## **Why the Correct Answer is Right**
The correct approach for a patient with NIDDM and a history of diabetes for one year involves understanding that diabetic retinopathy can occur even in the early stages of the disease. The ADA recommends that adults with Type 2 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist knowledgeable in the diagnosis and management of diabetic eye disease shortly after the diabetes diagnosis is made. For patients with no evidence of retinopathy at the initial examination, re-examination can be done every 1-3 years. Therefore, for a patient with a one-year history of diabetes, an ophthalmic examination is recommended.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option suggests an immediate examination, which might not be necessary if the patient has just been diagnosed and has no symptoms, but guidelines suggest an examination shortly after diagnosis.
- **Option B:** This option suggests a delay, which could miss early signs of diabetic retinopathy. Early detection is crucial for effective management.
- **Option D:** This option suggests a much longer interval, which would likely miss the window for early intervention in diabetic retinopathy.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that the diabetic retinopathy can be present even at the time of diagnosis of diabetes or shortly thereafter. Therefore, guidelines often recommend an initial eye examination shortly after the diagnosis of diabetes is made, with follow-up examinations based on the findings.
## **Correct Answer:** .