It is World Diabetes Day on Wednesday 14 November 2018. Sadly Type 2 Diabetes is widely considered to be amongst the most pressing concerns in the NHS as prevalence levels continue to increase dramatically.
With 3.8 million sufferers in the UK, more people than ever have diabetes. The number of adults diagnosed with Type 2 Diabetes in the past 20 years has almost doubled, and according to Diabetes UK 5 million people are expected to have diabetes by 2025 if nothing changes.
Diabetes is associated with complications such as blindness, stroke, cardiovascular disease, kidney failure and amputations.
The more common Type 2 Diabetes (where little insulin is produced, or insulin does not trigger an uptake in glucose in the body’s cells) is linked to obesity and smoking. It is the former which has reportedly driven the rate of increase cited above in recent times.
The RNIB and Specsavers jointly produced a State of the Nation Eye Health report in 2016. They found that of the 2 million people living in the UK with significant sight loss, half of those people could have been spared some degree of sight loss.
Of those 1 million people with avoidable sight loss, 5% have diabetic retinopathy (diabetic eye disease). Every year, 1,600 people are certified as visually impaired or severally visually impaired in England and Wales as a result of diabetic eye disease.
Diabetic retinopathy occurs when the tiny blood vessels at the back of the eye become blocked and leak but according to the RNIB is a condition that is often preventable.
Effective self-management of diabetes, including detection of early stage disease through regular eye screening and eye tests is crucial to prevent the development of this disease through swift referral and preventative treatment.
The existing 2006 national screening programme requires patients diagnosed with diabetes to be invited for national screening annually but the RNIB/Specsavers found a significant geographical and socio-economic variation in the screening uptake, with some patients getting them confused with their normal eye tests.
Back in 2016, the RNIB/Specsavers recommended that ideally, diabetes care should be better integrated with optometrists and other health professionals encouraged to support and coach patients to better manage their diabetes and also to remind patients that they need to have diabetic retinopathy screening and their eye test.
These strategies of course tie in to the wider healthcare funding debate in an era of austerity that is being had across the NHS. However as we see ophthalmology services come under increasing pressure and strain (with patients suffering avoidable injury in consequence), tomorrow is a great opportunity to raise awareness of the disease amongst the population at large and push it up the lobbying agenda.