Diabetes still a vision loss problem

Baltimore-Despite recent advances in prevention and treatment of most vision loss attributed to diabetes, a new study has shown that fewer than half of Americans with damage to their eyes from diabetes are aware of the link between the disease and visual impairment, and only 6 in 10 had their eyes fully examined in the year leading up to the study.

The research, described in the December edition of JAMA Ophthalmology, also found that nearly half of those with diabetes and eye damage had not visited a clinician charged with managing their disease in that same time period.

"As a nation, we are woefully inadequate as health-care providers in explaining to our patients with diabetes that the condition can have a detrimental effect on their eyes," said study leader Neil M. Bressler, MD, professor of ophthalmology at Johns Hopkins University School of Medicine and chief of the retina division at Johns Hopkins Wilmer Eye Institute. "The earlier we catch diabetic eye disease, the greater the likelihood that we can help patients keep their good vision.

“Clearly, this research shows how far we have to go to educate people about this frequent and feared complication,” he added.

For the study, the Johns Hopkins-led team of researchers used data collected between 2005 and 2008 from Americans enrolled in the National Health and Nutrition Examination Survey.

Among the 798 people over the age of 40 with a self-reported diagnosis of type 2 diabetes and who had retinal imaging done, 48 had diabetic macular edema (DME) and were asked in the survey whether a physician had told them about the link between diabetes and vision problems (44.7% were).

Patients were also asked whether they had seen a heath-care provider about their diabetes in the previous year (46.7% had), and whether they had received an eye examination, including pupil dilation, in the previous year (59.7% had).

Some 30% of the individuals with DME already had some type of vision loss related to the disease.

Dr. Bressler said some people fail to see eye doctors or diabetes educators because they lack insurance. He added that most of the problem is likely a lack of understanding about the risks, and most people probably aren't referred to eye care specialists who can quickly determine retinal vulnerability.

"We can prevent a lot of vision impairment or blindness if we can just get these people into the medical system," Dr. Bressler said.

Now that the extent of the problem is known, he continued, strategies can be developed to address issues of patient education, access to specialists and costs.

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