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Risk of ocular complications grows with prevalence of diabetes
Americans’ sedentary lifestyle and poor nutrition has growing repercussions for ophthalmology.
America is getting fatter. If this is news to you, you have not been paying attention. Major stories in national media outlets from the New York Times to CNN have highlighted Americans’ increasing girth. A RAND study this year linked obesity to higher health care cost increases than either smoking or problem drinking. The Institute of Medicine issued new nutrition guidelines earlier this year in the hope of encouraging us to slim down.
But the average American continues to “supersize” that sugary drink and plop down in front of the television to watch Tony Soprano, who also happens to be overweight, deal with his family problems. According to the American Obesity Association (AOA), 61% of Americans are overweight and 26% are obese.
We know where this leads. The prevalence of diabetes in the United States and other developed countries has increased dramatically in recent decades as sedentary lifestyles and poor nutritional diets have pervaded the Western world. The AOA says earlier onset of obesity-related diseases such as type-2 diabetes are being reported in adolescents and children.
Ophthalmologists know that this means their work is cut out for them in the coming years. Diabetic retinopathy affects 75% of all diabetics within 10 years of disease onset, and virtually all within 20 years. That means a lot of referrals, a lot of interaction with endocrinologists and internists and a lot of panretinal photocoagulation.
The last time our occasional series Population at Risk looked at diabetic retinopathy was in December 1997, almost 5 years ago. If the American Diabetes Association’s estimates are correct, as many as 120,000 people in the United States have been blinded by diabetes since that feature appeared. Also during that time a number of promising treatments for diabetic eye disease have advanced through clinical trials.
The editors of Ocular Surgery News thought it was time to take another comprehensive look at the ophthalmic risks to the diabetic population and the possibilities for management, now and in the future. The resulting suite of articles, by a trio of OSN staff writers, addresses the demographics of diabetes, issues in management and comanagement of diabetic eye disease, and the current options and future prospects for treatment.
We also present an account of a person living with diabetic eye disease, Peggy Easmunt. According to the ADA, a positive outlook like that expressed by Mrs. Easmunt can not only lead to better mental health but better ocular health as well. There is a message in her story for all of us.