Year-round resources for Diabetes Alert Day

Today is Diabetes Alert Day ^®, but fighting the disease is a 365-day engagement for doctors of optometry.

For instance, when the American Public Health Association (APHA) issued a report last fall on diabetes care, it focused attention on the importance of a multisystem approach to the disease’s management by four key health professionals—specifically dentists, pharmacists, podiatrists and eye doctors.

The role of eye health and vision care, delivered by eye doctors, was emphasized.

“Because millions of eye examinations are performed every year in the United States, eye doctors are commonly the first to detect diabetes and refer to primary care physicians or endocrinologists for initial systemic evaluations and medical management of disease progression,” the APHA report reads. “Also, eye doctors can easily refer to other subspecialties (such as dental care providers and podiatrists) for additional disease detection. Early diabetic eye disease is painless and commonly has no warning signs. Patients are frequently unaware that they have the condition, and the longer a person has diabetes, the greater the risk of sight-threatening diabetic eye disease. One of the more devastating complications of diabetes is diabetic retinopathy.

“Once vision is lost, it often cannot be restored,” it continues. “Preventing progression of diabetic complications is critical to maintaining a lifetime of high-quality vision. An annual, in-person, comprehensive dilated eye examination is the most effective way to detect the earliest signs of diabetes.”

Andrew Morgenstern, O.D., was the lead author on the proposed policy statement researched and hammered out by 11 APHA-member health care providers, representing dentistry, pharmacy, podiatry and eye care over an 18-month period. That diverse group of policy writers includes two other AOA members: Andrea Thau, O.D., former AOA president, and Glen Steele, O.D., professor of pediatric optometry, Southern College of Optometry. Dr. Thau served as section councilor and policy chair of the APHA Vision Care Section and helped guide the collaboration and resulting proposed policy statement from start to finish, even casting a vote to pass it as governing councilor.

Doctors of optometry—front-line providers

As front-line primary eye care providers, doctors of optometry impact the nation's health, especially when it comes to early diagnosis and intervention of patients with and at risk for diabetes, says AOA Board of Trustees member Lori L. Grover, O.D., Ph.D., who served on the guideline development group for the AOA clinical guideline Evidence-Based Eye Care of the Patient with Diabetes Mellitus, Second Edition.

The prevalence of diabetes has been called a growing epidemic.

Diabetes continues to be a leading cause of death in the U.S. According to the Centers for Disease Control and Prevention, about 34.2 million people in the country had diabetes in 2018. Another 7.3 million of those adults were unaware they have the disease, the CDC reports. Among the consequences for Americans—diabetic retinopathy, which is caused by high blood sugar and can damage the retina. In 2019, doctors of optometry detected an estimated 431,000 cases of diabetes in patients who were unaware they had the disease.

“Recent studies reinforce the public’s need for ongoing optometric eye care due to the demonstrated role doctors of optometry continue to play in diagnosing new cases of diabetes,” says Dr. Grover citing a study on Americans’ worsening blood sugar control at Johns Hopkins Bloomberg School of Public Health. “Blood sugar control among U.S. adults with diabetes declined significantly over the past decade. While a proportion of adults with diabetes achieving glycemic control improved from 1999 through the next 10 years, researchers found glycemic control has declined significantly, dropping from 57.4% (during 2007–2010) to 50.5% (during 2015–2018) and was also accompanied by a drop in the proportion of adults achieving blood pressure control. In addition, a recent nationwide increase in diabetes complications has been noted. These include increases in diabetes-related lower-extremity amputations, complications related to hyperglycemic crisis, a doubling of annual emergency department visits, increased hospitalizations by 73% percent, and deaths rising by 55% percent.

“The findings highlight the important role that doctors of optometry play in delivering readily accessible comprehensive optometric eye care that can prevent downstream sequelae like vision loss and related complications,” Dr. Grover adds. “Doctors of optometry are essential in facilitating early intervention through comprehensive eye examination to help minimize the impacts of one of our country's most prevalent and persistent chronic health conditions. The nation requires our clinical attention in order to improve U.S. population health."

Access AOA’s valuable diabetes resources

To raise public awareness about diabetes and support doctors of optometry integral in detecting the disease, the AOA has a collection of valuable resources including:

• The AOA’s evidence-based clinical practice guideline,  Eye Care of the Patient with Diabetes Mellitus, Second Edition, contains 31 recommended actions to enhance care of patients with diabetes. Listen to the podcast on the guideline.
• Members-only online courses can be accessed at EyeLearn Professional Development Hubincluding AOA Diabetes MastersClass: Diabetes Guidelines and AOA Diabetes MastersClass: Diabetes Education for doctors and paraoptometrics. Also available are paraoptometric-only courses on diabetes: Para Speaker Series-Navigating Diabetes: Vision, Eye Health & Wellness Facilitated by Paraoptometrics; Diabetes and the Eye; and Practice Success-Diabetes 101 for Paras.
• Resources at  AOA Marketplace include the updated  Diabetic Retinopathy Fact Sheet and other patient education materials.
• APHA recommends 17 actions for eye doctors, dentists, pharmacists and podiatrists for managing the care of patients with diabetes to get the best outcomes. Read and adopt actions in “A Call to Improve Patient and Public Health Outcomes of Diabetes through an Enhanced Integrated Care Approach.”
• Published in November 2021, the AOA Health Policy Institute paper,  Diabetes Clinical Management, Education, Prevention and Support Bilaterally Integrated through Optometry and Diabetes Care and Education Specialists, emphasizes the positive health outcomes afforded by doctors of optometry through collaboration.
• Consider 12 ways to provide better care for patients with prediabetes and diabetes.
• The American Diabetes Association offers the public separate 60-second online risk tests for diabetes and diabetic retinopathy.