Diabetes patients lose vision, and many don’t know why

by Bruce Sylvester – Less than half of Americans with eye damage caused by diabetes are aware of the connection between diabetes and visual impairment, researchers reported online on Dec. 19, 2013 in JAMA Ophthalmology.

Also, the investigators reported that almost half of the subjects with eye damage had not, in the year before the study, seen the clinician managing their diabetes treatment.

“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,” says study leader Neil M. Bressler, M.D., a professor of ophthalmology at the Johns Hopkins University School of Medicine, Wilmer Eye Institute, in Baltimore, Maryland. “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.

As, background, the authors noted that people with diabetes have at least a 10 percent risk of developing diabetic macular edema, and approximately 745,000 diabetics in the United States have swelling in the macula. Until recently, 15 percent of patients with macular edema treated with standard laser therapy still lost their vision.

But now, Bressler said, drugs injections into the eye reduce swelling and the risk of vision loss to less than five percent. With treatment about half of patients achieve vision improvement.

The researchers evaluated data collected between 2005 and 2008 from Americans enrolled in the National Health and Nutrition Examination Survey (NHANES).

Of 798 subjects over 40 years-old with a diagnosis of type 2 diabetes and history of retinal imaging, 48 had diabetic macular edema. They were asked in the survey whether a physician had told them about the link between diabetes and vision problems; 44.7 percent had been told.

They were also asked if they had seen a heath care provider about their diabetes in the previous year; 46.7 percent had. They were asked if they had received an eye examination, including pupil dilation, in the previous year; 59.7 percent had.

About 30 percent of the individuals with diabetic macular edema reported some type of diabetes-related vision loss.

Bressler noted that some people do not go to eye doctors or diabetes educators because they lack insurance. “We can prevent a lot of vision impairment or blindness if we can just get these people into the medical system,” Bressler added.