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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 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