DIABETES AND THE EYE: WHAT YOU SHOULD KNOW ABOUT IT

By

David Masihdas, O.D., P.C.(801) 363-2851

uea@xmission.com

Demographics

Total prevalence of diabetesTotal: 25.8 million children and adults in

the United States—8.3% of the population—have diabetes.

Diagnosed: 18.8 million peopleUndiagnosed: 7.0 million peoplePrediabetes: 79 million people*New Cases: 1.9 million new cases of

diabetes are diagnosed in people aged 20 years and older in 2010.

Who is affected by Diabetes

0.22 percent of people under the age of 20 years old have diabetes. 10.7 percent of people over the age of 20 have diabetes. 23.1 percent of people over the age of 60 have diabetes. 12 million men in the United States over the age of 20 have diabetes 11.5 million women in the United States aged 20 or older have diabetes African Americans have a 70% higher chance of getting diabetes over Caucasian Americans

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Why Does Diabetes Continue to Command Our Attention?

According to the CDCEVERY 24 HOURS there are:

4,100 new cases of diabetes, 810 deaths due to diabetes, 230 amputations, 120 kidney failures, and 55 new cases of blindness

Obesity Trends

1990 2001

Diabetes Trends1990 2001

BRFSS, 1990- 2001

Type 2 diabetes - risk factorsYou have a higher risk for diabetes if you

have any of the following:

Age greater than 45 years Diabetes during a previous pregnancy Excess body weight (especially around the waist) Family history of diabetes Given birth to a baby weighing more than 9 pounds HDL cholesterol under 35 mg/dL

Additional Risk factorsHigh blood levels of triglycerides, a type of fat

molecule (250 mg/dL or more)High blood pressure (greater than or equal to 140/90

mmHg)Impaired glucose toleranceLow activity level (exercising less than 3 times a

week)Metabolic syndromePolycystic ovarian syndromeA condition called acanthosis nigricans, which causes

dark, thickened skin around the neck or armpits

The Science of DM Control

Diabetes Control and Complications Trial (DCCT)

Compared effects of two diabetes treatment regimens – standard therapy and intensive control – on the complications of diabetes in people with type 1 diabetes

DCCT. New England Journal of Medicine, 329(14), September 30, 1993.

DCCT Findings

Glucose control is key to preventing or delaying complication of diabetes

Any sustained lower of blood glucose helps, even if the person has a history of poor control

DCCT Findings

Lowering blood glucose reduced risk of:

Eye disease by 76% Kidney disease by 50% Nerve disease by 60%

DCCT. New England Journal of Medicine, 329(14), September 30, 1993.

Economic ImpactThe cost of diabetes to the U.S. economy has increased 32

percent since 2002, or $8 billion a year, reaching $174 billion in 2007, according to estimates from the ADA.

1 in 10 Americans is at risk of being diabeticOne out of every five health care dollars is spent caring for

someone with diagnosed diabetes, while 1 in 10 health care dollars is attributed directly to diabetes, according to the ADA.

Medicine for diabetic cost approx. $7 B per year.Annual cost to treat a pre-diabetic is $5,000, undiagnosed

is $10,000 and diabetic with complications $30,000.Cost for a health employee is $ 1721/ yr vs a diabetic which

is $22512.

ETDRS Classifications of DRNo DRNPDR

MildModerateSevere

Very Severe NPDRPDR

Diabetes and the Eye

It affects:Cornea

Lids/Lashes

Lens

Retina

Cornea

Dryness

Tear deficiency

Tissue damage

Discomfort

Blurred vision

Lids/Lashes

Crusty

Glands atrophy

Loss of integrity

Don’t close normally

Loss of lashes

Lens

Retina

Diabetes MellitusDiabetes is the leading cause of preventable new-onset blindness in the United States.

Approximately 40% of Americans who would benefit from sight preserving treatment for diabetic retinopathy do not receive necessary care.

General referral Guidelines

Insulin dependent: * Newly diagnosed every 6

months * Dx 2-5 yrs good control,

every 6 months * Dx 6+ yrs good or poor

control more frequent

Non-insulin dependentNewly diagnosed every yearDx 2-5 yrs, good control every yearDx 6-10 yrs every 6 months

Invitation

Visit the Diabetic Eye CenterAt

150 South 1000 EastAnd see what level of care

Is delivered.Call 801.363.2851