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Diabetes Eye Health: A guide for Health Professionals

What is Diabetes Eye Health: A Guide for Health Professionals?

Diabetes Eye Health: A Guide for Health Professionals (the Guide) is a practical and informative document developed for primary health professionals on managing diabetic eye disease, in particular diabetic retinopathy (commonly called DR).

The Guide aims to raise awareness among health professionals about the growing prevalence of DR, and identifies the key roles and actions health care professionals can take in prevention, screening, monitoring, and referral.

The Guide, Diabetic Eye Health: A Guide for Health Professionals, was developed in response to the growing numbers of people with diabetes, particularly in low and middle income countries. It points to the important role of health professionals in identifying and facilitating management of DR and the need for collaboration across diabetes, eye and primary health sectors.

Blindness can be largely avoided with effective diabetes management, regular eye exams, and timely treatment. Ensuring all people with diabetes have access to these important health care services will require a new approaches in service provision and cross-sectoral collaboration. With the increase in the number of people developing diabetes, it is more important than

ever that both health practitioners and patients understand that diabetic retinopathy is largely avoidable, with the right care.

A copy of the Guide can be downloaded HERE

Who developed the Guide?

The Guide is an initiative of the International Diabetes Federation (IDF) and The Fred Hollows Foundation (The Foundation). It was developed in consultation with a working group of experts from a variety of disciplines and geographical regions. The disciplines represented were:

Ophthalmology Diabetology Optometry Primary Health Diabetes Education

Geographical regions represented were based on the regional structure of the World Health Organisation, and the seven IDF regions. They are as follows:

Africa Middle East and North Africa South and Central America Western Pacific

Europe North America and Caribbean South-East Asia

Why was the Guide developed?

There are a range of clearly defined clinical guidelines for diagnosis and treatment of DR developed for eye specialists, however, there is little advice written for those providing primary health services for people with diabetes on how to screen for DR and when to refer patients for further investigation.

In addition, clinical practice guidelines for the management of DR have been implemented throughout the world, but mainly in developed nations where there is access to quality resources and appropriate referral pathways. In low resource settings, it is important to provide practical and useful advice appropriate for the context.

Diabetes Prevalence Statistics – latest IDF Atlas figures as of 14th November 2015

1 in 11 adults have diabetes (415 million)

318 million adults have impaired glucose tolerance (6.7% of adults aged 20-79)

46.5% of adults with diabetes are undiagnosed

12% of global health expenditure is spent on diabetes (USD 673 billion)

Three-quarters (75%) of people with diabetes live in low- and middle-income countries

There will be an estimated 4.96 million deaths from diabetes in 2015

1 in 7 births are affected by gestational diabetes

542,000 children aged under 15 have type 1 diabetes

By 2040, 1 adult in 10 will have diabetes (642 million) and expenditure will exceed USD 802 billion

The number of people with diabetes is increasing rapidly, particularly in low and middle income countries

Every person with diabetes is at risk of going blind, and diabetic retinopathy is already the leading cause of blindness in working age adults.

Over 90 million people have diabetic retinopathy, and this number will rapidly rise unless effective action is taken.

What is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes in which the capillaries in the retina are damaged as a result of chronic hyperglycaemia (high and varying blood sugar levels). The damaged capillaries allow leakage in to the retina, disrupting its normal function, and capillary blockage, which restricts blood flow to the retina depriving it of oxygen. This can lead to loss of vision and eventually blindness. Diabetic retinopathy is generally asymptomatic until it becomes more severe. Many people with mild diabetic retinopathy have no symptoms. In more advanced cases however, blurred vision, floaters or sudden catastrophic loss of vision can occur in one or both eyes.

How can Diabetic Retinopathy be prevented and managed?

Blindness can be largely avoided with effective diabetes management, regular eye screening, and timely treatment. Ensuring all people with diabetes have access to these important health care services requires a new approach in service provision and cross-sectoral collaboration. Primary health workers are at the frontline of providing services to people with diabetes, and this must include screening for and monitoring diabetic eye health, and timely referral to eye specialists for further examination and treatment.

The Guide offers practical information to support this new cross-sectoral and collaborative approach to managing diabetic retinopathy.