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Diabetes: Something we can all agree upon
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It is rare to find a subject on which all parties agree, and health care is no exception. For instance, employers often contend health care expenditures consume a disproportionate share of operating expenses and pressure insurers to lower premiums. Insurers, in turn, trim costs by reducing provider reimbursement and patient benefits.
Providers respond by improving office efficiencies in an effort to see more patients without sacrificing quality. And patients, frustrated by high premiums and limited benefits, aren't sure where to turn to make the most their health insurance dollar! This is hardly a win-win situation.
Amidst the controversy there is one consistency, something we all agree upon - diabetes. The statistics about this disease are staggering: approximately 17 million Americans suffer from diabetes; approximately 75% of 20-year diabetics have some form of retinopathy. Of those with retinopathy, approximately 750,000 are at risk for vision loss due to clinically significant macular edema or proliferative retinopathy.
Indeed, diabetic retinopathy is the leading cause of legal blindness among working Americans. The consensus? Diabetics must receive accessible, comprehensive, quality health care.
Employers understand this, being all too aware of the tremendous cost, loss of productivity and disability associated with diabetes-related blindness. Insurers also realize this. The treatment cost - systemically and ocularly - for a poorly controlled diabetic far exceeds the cost of prophylaxis. Insurers are quick to support of diabetic education, dietitian services, prescription plans and annual eye examinations.
And clinicians clearly recognize the need for vigilant diabetic eye care. So why aren't all diabetics undergoing a dilated fundus examination at least annually? The answer often lies in patient education, or lack thereof.
Like other patients, diabetics can be confused and intimidated by health care. Uncertain about their plan's coverage, they simply stay away. Others just fail to understand the significance of their disease, and for these individuals no symptoms equates with no problems!
As primary eye care clinicians our role is larger than we think. Sure, all of us recognize our responsibility to provide quality care for the diabetic. We also understand the the importance of corresponding with other physicians. But, how do we size up as patient educators? If we do not alert our patients to the insidious nature of diabetic eye disease, who will?
Something to think about, especially when examining your next diabetic patient.