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Diabetic epidemic is here now

As a certified telemedicine diabetic reader I participate in a program ran through UC Berkeley called Eyepacs. Eyepacs is a web based non-proprietary application for exchanging eye-related clinical information. The bulk of Eyepacs communications involves bringing diabetic retinal assessments into the primary care physicians’ office. The program works without regard to physical location, is validated and is growing exponentially along with the number of diabetics. On this particular morning I am reviewing images from diabetic patients living in Mexico. Diabetes is a world wide epidemic.

Diabetes is projected to grow worldwide from 382 million people today to 592 million by the year 2035—that is an increase of 55%. About 46% of people with diabetes are undiagnosed and unaware of the long-term damage the disease presents to their bodies.

Along with retinal disease, diabetes also brings with it a host of other potential medical complications. Those include vascular disease such as peripheral vascular disorders, cerebrovascular disease (brain and cerebral circulation), oral health, heart disease, kidney disease and neuropathy.

According to the American Optometric Association, diabetes is the leading cause of new cases of blindness and low vision among patients ages 20 to 74 years of age. An estimated 25.8 million Americans have diabetes (8.3% of the population). In 2010 1.9 million new cases were diagnosed in people aged 20 or older. Based on that trend one third or one in three adults will have diabetes by 2050.

The most common complication of diabetes is eye disease (affecting 70%). In fact between 20-40% of patients with diabetes have retinal disease already present at the time of their original diagnosis. Unfortunately only about one half to one third of diabetics obtain annual dilated retinal exams. (Hence the need for Eyepacs). Race makes a difference in prevalence. For example the CDC estimates the prevalence of diagnosed and undiagnosed diabetes for Non-Hispanic blacks to be 18.7% versus 10.2% for the same age 20 and up Non-Hispanic whites.

Once a patient has diabetes the incidence of eye disease increases with the duration of Diabetes. Remember above that at the time of diagnosis 20-40% of type 2 (the most common type) diabetics have eye disease. That number grows to 60-80% after 15years with 20% of those progressing to the most severe form of eye disease called proliferative retinopathy.

If we look at the cost projections for diagnosed diabetes we see it is growing alarmingly. In 2007 it was estimated to be $174 billion and in 2012 it had grown to $245 billion. Based on the growing projections for 2050 it is going to create a staggering financial and social burden on healthcare. With 26 million Americans already having diabetes and that number growing the epidemic is upon us now.

We all can do our part by being more active, eating properly, avoiding smoking and getting routine preventative eye health exams. The earlier we diagnose and intervene in the diabetes disease process the less the cost and the better the  outcomes.