Lack of access to eye examinations is one issue.
(Press Release) NEWBURY, England — Despite vision loss being feared twice as much as other common complications of diabetes (including cardiovascular disease and stroke), a quarter of people with diabetes surveyed are not discussing eye complications with their health care professional, with many presenting when vision problems have already occurred.
These are some of the concerning insights into the current management of diabetic retinopathy (DR) and diabetic macular edema (DME) revealed by the DR Barometer Study, launched via a collaboration of experts from the International Federation on Ageing (IFA), International Diabetes Federation (IDF), International Agency for the Prevention of Blindness (IAPB) and Bayer Pharma AG. The DR Barometer Study shows that 79 percent of people with diabetic retinopathy find that their vision loss makes activities such as driving, going to work and completing basic household tasks difficult, and in some cases impossible. Furthermore, 20 percent of people with diabetic retinopathy or diabetic macular edema also cite that changes in their vision leave them less able to manage their diabetes, an issue reflected in individuals’ perception of their overall health, with over half of respondents with diabetic retinopathy 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," said Peter Ackland, CEO, International Agency for the Prevention of Blindness (IAPB). "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."
The DR Barometer Study highlighted major capacity issues affecting access to eye examinations, which form a critical step in the detection and management of diabetic retinopathy. This issue is illustrated by the fact that 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. One in three people with diabetes surveyed also confirm that even when they can book an appointment, the cost of the examination itself can be prohibitive, and 24 percent of patients said that waiting times at the clinic were a further issue.
As well as exposing inadequacies within healthcare systems, the DR Barometer Study uncovers a worrying lack of guidelines for healthcare professionals. It reveals that half of all providers surveyed do not have written protocols for the detection and management of diabetes-related vision issues. The combined issues around capacity and cost for delivering screening, along with a lack of clarity around guidelines delivers a "perfect storm" for this vulnerable population, both now and in the future, placing people with diabetes at risk of delays in diagnosis and treatment for diabetic eye disease. Close to two-thirds of ophthalmologists surveyed believe that late diagnosis is the greatest barrier to improving outcomes, with over half revealing that people with diabetes present when vision problems have already occurred and in many cases when it is too late for treatment.
"We are currently experiencing one of the most important demographic upheavals of our time in terms of global population ageing, and the impact of non-communicable diseases such as diabetes is rising at a rapid rate," said Dr. Jane Barratt, secretary general, International Federation on Ageing. "The DR Barometer Study exposes numerous barriers to timely screening, diagnosis and treatment for many people with diabetes – barriers which must be addressed head-on if we are to more effectively manage the consequences of these diseases as the at-risk group increases. 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."
Along with their detailed research findings, the IFA, IAPB and IDF have also harnessed the DR Barometer Study to deliver a number of key evidence-based recommendations to address the knowledge gaps and inequalities in services for people with diabetes. One crucial element of good patient outcomes is regular, affordable and accessible eye examinations for people with diabetes, along with affordable treatment delivered within a coordinated system, to ensure those at risk of vision loss are effectively monitored and managed.
The experts behind the DR Barometer Study are also calling for significantly increased education, both for people with diabetes and health care professionals, regarding the prevention, detection and treatment of diabetic retinopathy and diabetic macular edema. Equally important is the provision of tools for people with diabetes in all countries to be able to effectively manage their diabetes and prevent vision loss from occurring in the first place.
“The theme of this year’s World Diabetes Day is ‘Eyes on Diabetes,’ which reflects how critical we believe the role of eye health to be within diabetes management,” said Dr. David Cavan, director of policy and programmes, International Diabetes Federation. “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.” For further information and to download the full results of the DR Barometer, visit www.drbarometer.com.