Transcript Slide 1
DIABETES AND THE EYE:
WHAT YOU SHOULD KNOW
ABOUT IT
By
David Masihdas, O.D., P.C.
(801) 363-2851
[email protected]
Demographics
Total prevalence of diabetes
Total: 25.8 million children and adults in the
United States—8.3% of the population—have
diabetes.
Diagnosed: 18.8 million people
Undiagnosed: 7.0 million people
Prediabetes: 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
Why Does Diabetes Continue to Command
Our Attention?
According to the CDC
EVERY 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
1990
BRFSS, 1990- 2001
2001
Diabetes Trends
2001
Type 2 diabetes - risk factors
You 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 factors
High 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 tolerance
Low activity level (exercising less than 3 times a week)
Metabolic syndrome
Polycystic ovarian syndrome
A 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 Impact
The 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 diabetic
One 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 DR
No DR
NPDR
Mild
Moderate
Severe
Very Severe NPDR
PDR
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 Mellitus
Diabetes is the leading cause of preventable newonset 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 dependent
Newly diagnosed every year
Dx 2-5 yrs, good control every year
Dx 6-10 yrs every 6 months
Invitation
Visit the Diabetic Eye Center
At
150 South 1000 East
And see what level of care
Is delivered.
Call 801.363.2851