On World Diabetes Day, a consortium of international medical organizations is highlighting the fact that a quarter of people with diabetes are not discussing eye complications with their healthcare professional, despite a worldwide survey indicating that vision loss is feared twice as much as other common complications of diabetes.
Supported by the International Diabetes Federation (IDF), the International Federation on Ageing (IFA), and the International Agency for the Prevention of Blindness (IAPB), with funding from Bayer, the new Diabetic Retinopathy (DR) Barometer survey questioned almost 4340 adults with diabetes and 2329 healthcare professionals in 41 countries. Individual reports for specific countries are available here.
The results provide some unique insights into the current management of DR and diabetic macular edema (DME), especially with regard to access to eye exams and the knowledge of healthcare professionals when it comes to visual complications of diabetes.
Not surprisingly, 79% of people with DR said that their vision loss makes activities such as driving, going to work, and completing basic household tasks difficult and in some cases impossible.
Importantly, in addition, 20% of people with DR or DME said that the changes in their vision leave them less able to manage their diabetes, an issue that was reflected in individuals' perception of their overall health, with over half of respondents with DR rating their physical health as "poor to fair."
"Diabetic retinopathy is a leading cause of blindness in the working-age population of most developed countries, and the sight loss caused by this condition can have a profound impact on both an individual's quality of life and their ability to work," says Peter Ackland, chief executive officer, IAPB, in a press release.
"DR and DME can be successfully managed with the right screening and treatment; however, many people with diabetes are being placed at unnecessary risk of vision loss due to barriers within the referral system and patient care pathway," he noted.
Half of Healthcare Professionals Don't Have Access to Guidance on Diabetic Retinopathy
The number of people with diabetes globally has nearly quadrupled since 1980 to 415 million adults, with one in every 11 adults worldwide having diabetes, half of which are undiagnosed. People with diabetes living in low- and middle-income countries make up 75% of the diabetes population.
DR, the most common form of diabetic eye disease, is a complication caused by high blood glucose levels damaging the blood vessels at the back of the eye. DME is a frequent manifestation of DR, which occurs when blood vessels leak fluid into the retina, causing blurred vision. Both DR and DME can lead to blindness if undiagnosed and untreated.
All people with type 1 and type 2 diabetes are at risk of developing both DR and DME, but this can be prevented via effective risk assessment, early diagnosis, and appropriate management of diabetes.
The DR Barometer study has indicated that there are capacity issues affecting access to eye examinations, the critical first step in the detection and management of DR and DME.
Both ophthalmologists and adults with diabetes who participated in the study reported "long waiting times to schedule an appointment" as a major barrier to optimizing eye health.
And one in three people with diabetes surveyed said that even when they can book an appointment, the cost of the examination itself can be prohibitive.
The study also reveals that written protocols for the detection and management of diabetes-related vision issues are sorely lacking, with half of all healthcare providers surveyed noting that they do not have access to any such guidance.
This creates a "perfect storm," say the medical organizations, with close to two-thirds of ophthalmologists surveyed stating that they believe that late diagnosis is the greatest barrier to improving outcomes.
Over half of these eye specialists revealed that people with diabetes present when vision problems have already occurred and in many cases when it is too late for treatment.
Governments Urged to Prioritize Diabetic Eye Health
"The DR Barometer Study exposes numerous barriers to timely screening, diagnosis, and treatment for many people with diabetes — barriers that must be addressed head-on if we are to more effectively manage the consequences of these diseases as the at-risk group increases," notes Dr Jane Barratt, secretary general, International Federation on Ageing, in the press statement.
"A patient's age, where they live, or how much they earn should not be the defining factors in determining the management and treatment of their diabetes or any associated complications, such as diabetic eye disease," she stresses.
And David Cavan, MD, director of policy and programs, IDF, said the fact that the theme of this year's World Diabetes Day is "Eyes on Diabetes" "reflects how critical we believe the role of eye health to be within diabetes management.
"The DR Barometer Study offers a number of steps that need to be taken now to prevent further vision loss from diabetes, and we urge governments around the world to seriously consider how current approaches to diabetic eye disease can be improved," he asserts.
The research was made possible with support from Bayer Pharma.
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Cite this: Eye Is the Focus of World Diabetes Day in 2016 - Medscape - Nov 14, 2016.