Reducing retinopathy in patients with type 1 diabetes

The frequency and severity of retinopathy in patients with type 1 diabetes are decreasing, according to two recent studies.

Improved diabetes care—especially better insulin management—is the likely reason suggested by the studies, which were funded by the National Institutes of Health (NIH).

"Optometrists must play an active role in educating patients."

"This research affirms that overall strict diabetes management is a necessary component of care for diabetes-related eye conditions," said Michael R. Duenas, O.D., AOA chief public health officer. "Optometrists must play an active role in educating patients with diabetes on the effective management of their condition."

Dr. Duenas encourages optometrists to counsel patients on good diabetes management even before diabetic retinopathy is found. They should record glucose levels, A1C, body mass index (BMI) and other pertinent information in the patient record. They also should share their findings and treatment recommendations with other practitioners on the patient's care team.

What the research shows

The research suggests more intensive insulin management and diabetes care, implemented over recent years following the Diabetes Control and Complications Trial (DCCT), has changed the retinopathy prognosis for people with type 1 diabetes. The DCCT found intensive glucose control slowed the onset and progression of diabetes-related eye, kidney, and nerve damage. It also improved the overall health of diabetes patients.

The new studies compared the results of diabetes care before and after publication of the DCCT. A group of 305 subjects from the Wisconsin Diabetes Registry Study (WDRS) received retinal examinations from 2007 to 2011. A group of 583 subjects from the Wisconsin Epidemiological Study of Diabetes Retinopathy (WESDR) received retinal examinations from 1980 to 1996.

Researchers found the frequency and severity of diabetic retinopathy was lower for individuals in the WDRS group compared with those in the WESDR group.

"This research gives optometrists and other health care practitioners a powerful new tool to help encourage strict patient compliance with diabetes care regimes," Dr. Duenas said. "It shows that patients with diabetes can help save their eyesight—the sense people value most—by controlling their systemic condition." 

Resources for diabetes care

  • The AOA offers online resources for optometrists, paraoptometrics, health care practitioners, diabetes educators and the general public on diabetic retinopathy and the importance of eye care.
  • The AOA Marketplace includes brochures and other print resources optometrists can use to help educate patients with diabetes on proper care.

October 3, 2013

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