Diabetic Retinopathy: Don’t Look Away

Posted by Cynthia Lank on Apr 17, 2019 10:16:20 AM
Cynthia Lank

There are many ways to look at the impact of any disease, such as the patient experience, the public health impact, and the related healthcare costs, to name a few. In this blog post, we’ll take a look at the some of the statistics related to diabetic retinopathy (DR) – numbers that challenge physicians, the healthcare system as a whole, and patients to consider how to prevent, detect, and treat this eye disease that can blind.

We can’t talk about DR without talking about diabetes – the underlying cause of DR. According to the American Diabetes Association, 1.5 million Americans are diagnosed with diabetes every year, and this chronic disease is estimated to affect over 30 million Americans (or 9.4% of the population). People with diabetes are at risk of serious and debilitating macrovascular and microvascular complications, including DR. The good news… 90% of diabetes-related blindness is preventable. The onset and progression of DR can be prevented or slowed with optimal management of blood glucose, blood pressure and cholesterol. In addition, treatments are available to limit the vision loss due to DR. However, because DR in its early stages can be asymptomatic, detection via screening and timely treatment are essential. The bad news… despite recommendations from the ADA for regular retinal screening, many people with diabetes are not screened. The imperative for more widespread screening for DR is best illustrated by the stark statistics on DR in the US: In 2014, a study estimated the prevalence of DR to be ~8,100,00 and projected this number to rise to ~11,000,000 in 2032 and to ~13,200,00 in 2050.

Millions of individual Americans and their families already are or will be affected by varying degrees of vision loss due to DR. Importantly, vision loss is associated with other health issues such as depression, falls, cognitive decline, and premature death. And, of course, vision loss impedes people’s ability to perform daily tasks such as driving, reading, and traveling, all of which negatively impact their quality of life and productivity. Society as a whole is also affected, as the cost of diabetes in 2017 was estimated by one study to be $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity. This same study estimated the contribution of condition-specific complications of diabetes (e.g., cardiovascular, renal, ophthalmic, etc.) expenditures to total U.S. healthcare expenditures, and found that 25% of expenses were attributable to ophthalmic conditions.

Tackling the human and financial impact of DR will require strategies to prevent diabetes and to help people with diabetes better manage their disease to prevent DR. In addition, innovative screening strategies must be implemented to ensure that more people with diabetes have their eyes screened at appropriate intervals in order to detect DR and treat it before it causes irreversible vision loss.

References:

American Diabetes Association. Statistics About Diabetes. Available at: http://www.diabetes.org/diabetes-basics/statistics/

American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care 2018 Mar; dci180007. https://doi.org/10.2337/dci18-0007

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