Many With Diabetes Don't Realize Disease Can Harm Vision
Researchers say patient education, more proactive care could stop damage in most cases
"This paper is an excellent example of where the American health care delivery system has fallen down in an area where we can clearly do better," Ratner said.
For the study, researchers used survey data collected by the U.S. Centers for Disease Control and Prevention between 2005 and 2008 to review the responses of people with type 2 diabetes who had "diabetic macular edema." This condition occurs when high blood sugar levels associated with poorly controlled diabetes cause damage to the small blood vessels in the retina, the light-sensitive tissue lining the back wall of the eye.
As the vessels leak or shrink, they can cause swelling in the macula -- a spot near the retina's center that is responsible for your central vision. Macular edema can ruin your ability to see detailed images and objects directly in front of you, and ultimately can lead to permanent vision loss.
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.