Alternatives in eye care for patients with diabetes mellitus

The consultation strongly recommended that, if a screening and detection programme is implemented, resources be found for necessary laser treatment. From a pubic health perspective, detecting disease that cannot be treated is a poor use of resources. The participants recognized the importance of finding new methods for providing the resources necessary to deliver care within the changing international intelectual property rights regime. While education regarding the presence of retinopathy that...

Conduct international research into systemic deficiencies in health and eye care that contribute to blindness from

Improvements to increase the cost-effectiveness of eye care for diabetes patients are a global necessity. Blindness due to diabetic retinopathy occurs in part because factors important to both patients and health care providers have not been recognized or incorporated into current diabetes education, screening and treatment programmes. Systems analyses are needed in varous cultures to understand better why patients with diabetic retinopathy go bind, particularly when the technical knowledge and...

Expected UtCe Recommendation regarding the diabetic retinopathy content of

Diabetic patient education materials. Drafts of screening protocols for the early detection of diabetic retinopathy in different health care settings. Strategies for prevention of blindness due to diabetes with the pubic health perspective and as appropriate to existing resources and d ferent levels of technological application. Identification of opportunities and approaches to improve interaction and collaboration between eye care providers and other members of the diabetes management team.

Member States should choose the most appropriate method for detecting or screening for diabetic retinopathy

It is recommended that the following performance characteristics be considered in assessing reliability in detecting and grading the severity of retinopathy A seven-field photographic standard or a dilated indirect ophthalmoscopic and stereoscopic macular examination by a retina specialist experienced in diabetic retinopathy are the two gold standards. Nevertheless, specific photographic systems have been validated against these standards, with high agreement at similar levels. Use of speciic...

Technical issues in the use of standard photographic images

In view of the interest in photographic systems, much work has been devoted to specific technical issues (72,75), including the number of photographs needed the fields to be used if the full seven-field set is not used whether photographs should be taken through dilated pupils and who should interpret the photographs. In 2004, the American Academy of Ophthalmology concluded that, in the United States, single-field photography is adequate for screening for the purpose of detecting diabetic...

Use of digital images

The original reference studies, the Diabetic Retinopathy and Early Treatment Diabetic Retinopathy studies, were conducted with high-quality photographic film images, which require time and money to process, develop and then ship for interpretation. The advent of digital photography and high-speed internet connections have made the use of electronic images feasible. It is not, however, clear that all electronic images are as accurate or useful in image interpretation as film. Basu et al. (78)...

Use of photographic systems by nonphysician nonprofessional providers

The use of non-physician health care professional examiners for detecting diabetic retinopathy has been coupled with use of photographic systems in the United Kingdom (84,85). The performance of trained photographic readers using a Polaroid camera system has matched or exceeded that of physicians and optometrcs. An accuracy of more than 90 in staging retinopathy has been reported with a modified Early Treatment Diabetic Retinopathy Study system that is similar to the International Clinical...

Delivery of eye care for patients with diabetes

Despite clearly defined clinical guidelines for evaluating and treating diabetic retinopathy in a cost-effective manner, effective interventions, such as laser treatment, are underused, for a variety of reasons. While the available resources and methods differ from country to country, certain basic components of care should be present. Patients should know that they have diabetes mellitus and that the condition requires care. General population screening for diabetes mellitus with existing...

Evaluation and improvement of eye care for patients with diabetes mellitus

In assessing approaches to improving the care system, it is important to (i) determine the purpose of the proposed system, for example, to screen for a threshold referral level of retinopathy or to provide guidance in management (ii) assess the performance of the system relative to that of the gold standard, in order to identify trade-offs (ii) assess the success and actual performance of different eye care systems in various settings and (iv) understand how patients perceive the benefits of...

United Kingdom Prospective Diabetes Study

These studies are notable for two additional findings. First, there is no threshold below which diabetic retinopathy does not occur when glycosylated haemoglobin is elevated rather, there is a linear relationship between achieved glycosylated haemoglobin level and the risk for visual complications of diabetes. Secondly, persons receiving intensive control had a significant rate of hypoglycaemic reactions, which might argue against such aggressive control in every situation. The choice of a...

Principles In Eye Care For Patients With Diabetes

Diabetic retinopathy remains the leading cause of new-onset blindness in populations of working age, even in the United States (21) and other industralized countres. Despite clearly defined clinical standards for evaluating and treating diabetic retinopathy cost-effectively, for a variety of reasons (see below), effective treatments such as laser surgery are underused. It has been estimated that 50 of adults with diabetes mellitus in the United States do not receive the recommended annual eye...

Education about eye health among patients with diabetes should be patientcentred

Pubic awareness about diabetes mellitus and diabetic retinopathy is lacking in all societies. It is recommended that health education about these conditions be intensified, and education material and campaigns be oriented to address issues from the patient perspective and not solely that of the provider. Providers and organizations should therefore reassess their educational campaigns and change them into marketing campaigns. Health education must involve local populations and health care...

Agenda purpose and expected outcome

The global burden of diabetes mellitus and complications Current burden and trends Diagnosis and classification of complications of diabetes mellitus Clinical practice guidelines for diabetes and its complications Eye care deficiencies contributing to blindness from diabetic retinopathy Improving integration of eye care within diabetes management Patent and pubic education and awareness Core content of patient and pubic diabetic retinopathy education Materials Disease and its complications...

Global Prevalence Of Diabetes Mellitus And Its Complications

2 1 Current burden Diabetes mellitus is among the leading causes of death, disability and ' economic loss throughout the word 2,3 . WHO has estimated that there and trends were 171 million people wordwide with diabetes mellitus in 2000 and predicted that 366 million people will have diabetes mellitus by 2030 4 . The increase will be due mainly to increases in low- and middle-income countries Figure 1 . The International Diabetes Federation has estimated that another 314 million persons have...