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Many With Diabetes Don't Realize Disease Can Harm Vision

Researchers say patient education, more proactive care could stop damage in most cases

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Many diabetics suffer from diabetic macular edema. People with diabetes have at least a 10 percent risk of developing the eye disease during their lifetimes, Bressler said. Recent reports estimate that the eye disease affects about 745,000 people with type 2 diabetes in the United States, the authors noted in background information.

The people in the survey with diabetic macular edema responded to questions about their medical care. The Johns Hopkins researchers gleaned their findings from the survey responses.

"We have to really strengthen our efforts at educating people who have diabetes about the eye complications," Bressler said. "They need to get to health care providers who can provide the appropriate treatment. In the United States, we aren't doing as good a job as we probably should."

Bressler, who is the editor of JAMA Ophthalmology, does not participate in deciding whether studies from Johns Hopkins are chosen for publication in the journal.

Ratner said part of the problem is that people can't afford to see a doctor for their diabetes. "I'm hopeful that as the number of uninsured individuals begins to drop, that structural problem will get better," he said.

On the other hand, doctors need to do a better job when they do see patients of emphasizing the dangers of vision loss from diabetes in a clear manner, Ratner added.

"Diabetes is an overwhelming disease," Ratner said, arguing that doctors likely told patients about the potential for vision loss but that the message was lost in the crush of diabetes information they regularly receive. "We need to learn how to communicate in a way they can handle it, and help them take control of their condition."

Doctors also need to enforce standards of care. Type 2 diabetics ought to receive full eye examinations with pupil dilation every two years, Ratner said.

"Our standards of care say these patients should be promptly referred to an eye specialist," Ratner said. "We will continue to push for health care professionals to meet the minimum standards of care."

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