#FOCUSED EYE CARE TRIAL#

Approximately one in five people with diabetes worldwide have some degree of DRD-an estimated 103.12 million individuals-of whom ~28.5 million have vision-threatening DRD. The International Diabetes Federation (6) estimates that the total number of people with diabetes globally will increase from 536.6 million (10.5% of the world's population) in 2021 to 783.2 million by 2045. The alarming increase in diabetes prevalence worldwide has resulted in large part from the growing prevalence of obesity, although prevalence rates of both type 1 diabetes and type 2 diabetes have increased, suggesting that other causes are also at play. Nevertheless, DRD remains a leading cause of vision impairment and blindness worldwide (5), and, crucially, is a major concern of people with diabetes and their families. Analogous long-term benefits also persist for diabetes-related kidney disease (4). Thus, the technical means to maintain good vision are available now. After 18 years of follow-up, DRD categorized as mild nonproliferative disease or less was maintained without further progression in 68% of people in the DCCT's intensive therapy cohort and 49% of those in the conventional treatment cohort (2,3).

#FOCUSED EYE CARE TRIAL#

Vision loss from DRD is preventable, as was demonstrated in the Diabetes Control and Complications Trial (DCCT) and its ongoing follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. We also discuss the challenges of and opportunities to improve the detection and timely treatment of DRD in all people with diabetes, with a particular emphasis on individuals who are socioeconomically disadvantaged or face other significant impediments to obtaining recommended eye care services. Here, we describe the health status information ECPs need from HCPs, and the eye examination reports HCPs need from ECPs to improve diabetes and eye health outcomes for the patients they share. The principles set forth in the first compendium remain the basis for the clinical practice of ECPs when treating people with diabetes. In this compendium, we have chosen to use the term “diabetes-related retinal disease” (DRD) to reflect the involvement of the entire retina, including both vascular and neural elements. The current publication builds on that foundation to address pragmatic approaches to improving bidirectional communication between eye care professionals (ECPs) and primary and specialty diabetes health care professionals (HCPs) and reducing barriers to diabetes-related eye care. The first publication focused on the medical and ocular features of diabetes-related eye disease and its diagnosis and treatment. This compendium, “A Practical Guide to Diabetes-Related Eye Care,” follows a 2019 compendium titled “Prevention and Management of Diabetes-Related Eye Disease” (1).

Focused eye care