New Research Points to a 'Perfect Storm' in Canada for Eye Disease from Diabetes

Thursday, May 24, 2018 Research News
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World's Largest Diabetic Eye Health Study Highlights Urgent Need to Reduce Unnecessary Risk of Vision Loss

  • Diabetes is a leading cause
    of blindness in Canada.1
  • 2 million Canadians are affected by diabetic retinopathy (DR), a complication of diabetes, which can lead to blindness if left untreated.2
  • Vision
    loss is feared twice as much by Canadians as other common complications of diabetes (e.g. cardiovascular disease and stroke), however only a quarter of people with diabetes are discussing eye complications with their physician, with many presenting when vision problems have already occured.1
  • With the number of people in Canada living with diabetes expected to reach 4.2 million by 20203, along with a growing aging population, action is urgently needed to address this major health and societal concern.

TORONTO, May 24, 2018 /CNW/ - The International Federation on Ageing (IFA) is pleased to announce the Canadian results from a multi-country study of almost 7,000 adults with diabetes and health care professionals from 41 countries.  In collaboration with the International Diabetes Federation, and the International Agency for the Prevention of Blindness, the IFA conducted the first of its kind, comprehensive, two-phase study that investigated issues surrounding diabetic eye disease (DED), primarily diabetic retinopathy (DR), and diabetic macular edema (DME).  The global data provides a unique perspective of diabetes-related eye diseases around the world, however there are many areas of alarm for Canadian populations, based on the study.

"May is Vision Health Month and a perfect opportunity to launch the Canadian results from this landmark initiative that captured both the patient and physician perspective on diabetes-related eye disease, yielding some truly Canadian insights," says Dr. Jane Barratt, Secretary General, IFA. "We have cause to be worried!  The study showed gaps in the current management of diabetic eye diseases and we now need to focus our attention on addressing these areas, to prevent unnecessary blindness."

DR Barometer demonstrated that there was a relatively high awareness of the complications associated with diabetes among Canadian respondents.  Vision loss (50%) was by far the most concerning, followed by kidney disease and cardiovascular disease.  While nearly half (46%) of those surveyed had no complications there were still many who reported having neuropathy, kidney disease, and vision loss.

Nearly three out of every four of those with DED or DME said that their vision was slightly or significantly affected which in turn impacted their health, lifestyle, and life choices. One third of respondents with DED reported mentally unhealthy days. However, 71% of those with DED experienced days where their activities were limited due to poor physical or mental health, compared with just over half of those without DED.

According to the study nearly two-thirds of those Canadians with DED and DME experienced difficulty in driving a vehicle, working or keeping a job, and undertaking household responsibilities, such as cooking or cleaning.

"In the early stages of diabetic retinopathy there may be no symptoms which is why it is especially important for people living with diabetes to have regular eye exams," says Dr. Jan Hux, President of Diabetes Canada. "Our Guidelines state individuals older than 15 years with type 1 diabetes should be screened annually beginning five years after the onset of diabetes, and all individuals with type 2 diabetes should be screened at the time of diagnosis and regularly thereafter.  Helping prevent diabetes related vision loss requires close collaboration between patients and their health-care provider, as well as ensuring all people with diabetes have access to evidence-based screening and treatment," says Dr. Hux.

A proactive treatment approach to prevent further vision loss was preferred rather than reactive treatment once further vision loss had occurred.  For some respondents (17%) access to healthcare was affected by where they lived in the country.  Health (46%), money (23%), and family (13%) were the top three 'worries' on the minds of the respondents surveyed.

Dr. Barratt remarks, "education is at the heart of a proactive approach to manage the threat of preventable blindness.  The data is quite clear and showed us that the current information is not adequate for patients and in reality only half of the ophthalmologists in the study had written detection protocols for staff and in some instances, educational material didn't even exist."

Eye disease from diabetes will continue to be major health risk in Canada, one that threatens the vision health of Canadians and an array of social and economic consequences.  It has been well-reported that Canada is in the midst of a demographic shift and by 2050, 26 per cent of the total population will be aged 65 years and older, while those aged 0-14 years of age will make up about 15 per cent of the population.  Alongside the demographic changes, the prevalence of diabetes is also climbing rapidly with over 2.5 million people currently living with diabetes - this number is expected to double by 2020.  The system costs of diabetes-related health expenditures will continue to grow with an estimation of $27 billion CAD, by 2040.4  

The IFA and partners urge policy makers to closely evaluate the situation in Canada and ensure effective policies and procedures are in place to manage current DED cases and strategies that will combat the anticipated demands issue in years to come.

About Diabetic Eye Disease

Diabetes remains one of the largest global public health concerns.  The number of people with diabetes has nearly quadrupled since 1980 to 415 million adults.3,5

DR, the most common form of diabetic eye disease, is a complication of diabetes 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 DR and DME, which can be prevented via effective risk assessment, early diagnosis, and appropriate management of diabetes.

About the DR Barometer

To investigate the global, regional and specific country issues surrounding DR and DME, the International Federation on Ageing (IFA), the International Agency for the Prevention of Blindness (IAPB) and the International Diabetes Federation (IDF) conducted a comprehensive, two-phase, multi-country study. 

Phase one was a qualitative study comprising interviews in eight countries that represented a cross section of regions and income levels.  Phase two was a quantitative study comprising desk research and the generation of new data from of a specifically designed, web-based survey of 4,340 adults with diabetes and 2,329 health care professionals in 41 countries.

The study population of adults with diabetes who participated in the survey was self-selected, predominantly from patient organizations as well as membership organizations of older adults (seniors). Therefore, this population group comprises people who are more likely to be engaged and motivated in the management of their diabetes.  Likewise, the health care professionals (providers) are self-selected and the same principle should be applied when interpreting the results.

About the Partners

The International Federation of Ageing (IFA) is an international non-governmental organization (NGO) with a membership base comprising government, NGOs, industry, academia, and individuals in 70 countries. IFA is a voice alongside and on behalf of older adults globally and has General Consultative Status at the United Nations and its agencies including the World Health Organization. For further information visit: https://www.ifa-fiv.org/

The International Diabetes Federation (IDF) is an umbrella organization of over 230 national diabetes associations in 170 countries and territories. It represents the interests of the growing number of people with diabetes and those at risk.  The Federation has been leading the global diabetes community since 1950. For further information visit: http://www.idf.org/

The International Agency for the Prevention of Blindness (IAPB) is the coordinating membership organization leading international efforts in blindness prevention activities.  IAPB's mission is to eliminate the main causes of avoidable blindness and visual impairment by bringing together governments and non-governmental agencies to facilitate the planning, development and implementation of sustainable national eye care programs. For more information, please visit: http://www.iapb.org

REFERENCES

___________________________1 Diabetes Canada - https://www.diabetes.ca/diabetes-and-you/complications/eye-damage-diabetic-retinopathy 2 Diabetes Canada - https://www.diabetes.ca/diabetes-and-you/complications/eye-damage-diabetic-retinopathy 3 Diabetes Canada - https://www.diabetes.ca/diabetes-and-you/complications/eye-damage-diabetic-retinopathy 4 DR Barometer Report

SOURCE International Federation on Ageing



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