24-Hour Crisis Hotline: (877)SAFEGBC or (877)723-3422 Mental Health & Substance Abuse Issues

6502 Nursery Drive, Suite 100
Victoria, TX 77904
(361)575-0611
(800)421-8825

Diabetes
Resources
Basic InformationLatest News
Diabetes Treatment Failure May Actually Be NonadherenceArtificial Intelligence Can Detect Diabetic RetinopathyMore Than 1 in 10 Patients May Be Overtreated for DiabetesPioglitazone Has Limited Effect in Lipoatrophic DiabetesFracture Risk Higher for Seniors With DiabetesCGM Use in Pregnancy Improves Neonatal OutcomesClosed-Loop Control Benefits T1DM in Prolonged Winter SportHeath Tip: Dining Out If You Have DiabetesExenatide Doesn't Up Cardiovascular Risk in T2DMIncreasing Salt Intake Tied to Diabetes RiskSotagliflozin Linked to Improved Glycemic Control in T1DMGreater Awareness Needed for Potential of T2DM RemissionCan Coffee or Tea Extend Survival With Diabetes?Could Artificial Sweeteners Raise Your Diabetes Risk?Could Swine Flu Be Linked to Type 1 Diabetes?'Upside' to Diabetes Really Isn'tLifestyle Tips for Better Diabetes ControlDiabetes Threatens Kidneys, Vision of Millions of Americans2017 Standards of Medical Care in Diabetes ReleasedBiomarkers Can Predict Rapid Drop in Renal Function in T2DMMany Teens With Type 1 Diabetes Report Disordered EatingCognitive Test Predicts Elderly Insulin Injection SuccessHigher Event Rate of T2DM in Polycystic Ovary SyndromeNovel Genetic Variant in IGF2 Linked to Reduced T2DM RiskFatty Acid Remodeling Seen in T2DM Remission Post Bariatric SxDiacerein Reduces Mean Hemoglobin A1c Levels in T2DMHealth Tip: Risk Factors for PrediabetesTablet Use Encourages Patients to Explore Diabetes RiskOnce-Yearly Counseling Tied to More Physical Activity in T2DMIn T2D, Glycemic Control Up With Continuous Glucose MonitoringSecure Messaging Linked to Better Diabetes ManagementStudies Often Fail to Include Info on T2DM Medication AdherenceIntensive Blood Pressure Tx Aids Those With PrediabetesLifestyle Intervention Only Offers Modest Benefit in Type 2 DiabetesSleep Duration Inversely Linked to Risk Markers of T2DM in KidsCould Big Lifestyle Changes Be Key to Managing Type 2 Diabetes?Variation in Participation in Diabetes Self-Management ClassTeam-Based Online Game May Improve Glycemic Control in T2DArtificial Sweeteners Trick the Brain: StudyCharacteristics of Diabetes in Infancy ExploredImmunotherapy Shown Safe in Type 1 Diabetes Clinical TrialOnline Game Helps Those With Diabetes Control Blood SugarHeart Health Ignored by Many With Type 2 DiabetesMortality Down Only for Gastric Bypass Patients With DiabetesInstagram Shows How Diabetics Really Wear a Glucose MonitorWhat Diabetics Need to Know About Over-the-Counter MedsEngineered Skin Cells Control Type 2 Diabetes in Mice: StudySimilar Defects ID'd for T2DM, Chronic Pancreatitis and DiabetesDiabetes Symptoms Appear to Spread Via Prion-Like MechanismPoor Adherence to Self-Monitoring of Glucose in GDM
Links
Related Topics

Medical Disorders

Is Annual Eye Exam a Must for People With Type 1 Diabetes?

HealthDay News
by By Alan Mozes
HealthDay Reporter
Updated: Apr 19th 2017

new article illustration

WEDNESDAY, April 19, 2017 (HealthDay News) -- People with type 1 diabetes face the risk of developing a disease that can cause blindness, so treatment guidelines have long called for annual eye exams.

But new research suggests this one-size-fits-all advice is costly and ineffective, because people with a low risk may need less-frequent screenings while people at high risk may need to be seen more often.

Diabetic retinopathy can damage the light-sensitive tissue at the back of the eye and trigger full vision loss, the researchers explained. Screening can catch this disease before irreparable damage is done, but not every person with diabetes faces the same risk.

"For example, patients with no or minimal eye changes and good blood sugar levels might not need their next examination for another four years," said study author Dr. David Nathan.

"On the other hand, if the patient already has developing eye disease and their blood sugar control has not been in the recommended range, they might need a repeat examination in as soon as three months," he added.

Nathan is the director of the Diabetes Center and Clinical Research Center at Massachusetts General Hospital, in Boston.

Current guidelines suggest getting an annual eye screening within three to five years of a type 1 diabetes diagnosis. People with type 1 diabetes cannot produce any insulin.

To assess that advice, the investigators focused on type 1 diabetics (aged 13 to 39) who had enrolled in a large, national diabetes trial between 1983 and 1989.

The latest analysis involved 24,000 eye exams conducted over 30 years among roughly 1,400 people with type 1 diabetes.

Retinal photographs were taken every six months until 1993, and then -- in a follow-up study -- once every four years until 2012. The study participants' vision, advanced retinopathy status and general diabetes history were tracked for an average of nearly 29 years.

The researchers determined that those participants who had an average blood sugar level of 6 percent, but no signs of retinopathy, could forgo the annual screening in favor of just one exam every four years. Similar people with mild retinopathy should be screened once every three years, the team concluded.

By contrast, those with severe or moderate retinopathy would do well to get screened every three to six months, respectively, the study authors reported.

People with higher blood sugar levels (8 to 10 percent) might also need to be screened more often, the researchers cautioned.

On average, the new recommendations for people with type 1 diabetes would likely cut the need for eye exams in half over a two-decade period. That would translate into an overall savings of $1 billion, while ensuring that those facing the highest risk got more timely treatment, the researchers said.

The findings were published in the April 20 issue of the New England Journal of Medicine.

Nathan described the results as "definitive." However, he said the jury is still out as to "whether the individualized frequency of eye examinations will be implemented by physicians" and followed by people with type 1 diabetes.

"The risk is that physicians may find it easier to schedule an annual eye examination compared with the new individualized schedule, which may be more difficult for physicians and patients to remember," he acknowledged.

"However, most physicians and ophthalmology offices use computer programs -- including reminder programs -- for scheduling, so we think that this potential barrier should not be a substantial obstacle," Nathan added.

Courtney Cochran, senior manager of media relations for the American Diabetes Association (ADA), noted that the ADA issued updated guidelines for retinopathy screenings in February.

The new recommendations now state that people with type 1 diabetes should start annual screenings within five years of their diabetes diagnosis. But those who remain free of retinopathy for a year or two may "consider" the option of less-frequent exams.

However, the ADA also said that if and when "any level" of retinopathy is detected, annual screenings are a must, while those with progressing retinopathy will require even more frequent screenings.

Dr. Jamie Rosenberg, who wrote an editorial that accompanied the study, suggested the new recommendations reflect "a trend toward reducing unnecessary screening for eye diseases."

"The upside to this new screening protocol would be significant money saved for the health care system, in addition to time saved for both patients and doctors," said Rosenberg, who is an associate professor of clinical ophthalmology and visual sciences at the Albert Einstein College of Medicine, in New York City.

Individualized schedules will make tracking patients more difficult, Rosenberg agreed. But, "this new screening protocol has great potential if adherence to the examination schedule could be assured."

More information

There's more on diabetes-related advanced retinopathy screenings at the American Diabetes Association.