Do you know someone who has diabetes? Are you managing the condition yourself?
Almost certainly, you’ve answered ‘Yes’ to the first question and you may also have answered ‘Yes’ to the second. In fact, Diabetes Australia estimates that approximately 1.7 million Australians are currently living with diabetes, with about 275 new cases every day.
July 14 – 20 is National Diabetes Week and I’d like to tell you about one of the fantastic Vision Initiative activities: the Diabetes and Eye Health project. This project aims to increase rates of eye examinations in people with type 2 diabetes, and to improve the early detection and management of diabetic retinopathy – a condition that can lead to blindness in people with diabetes. It is being conducted as a collaboration between Vision 2020 Australia, Diabetes Australia – Victoria and The Australian Centre for Behavioural Research in Diabetes.
Image: Amelia Lake
Before I tell you more about the project, let’s take a step back and look at diabetes. There are three forms of diabetes: type 1, which can occur at any age, but is more often diagnosed in children and young adults; gestational, which occurs during pregnancy and goes away after the baby is born; and type 2, which is by far the most common form, accounting for 85-90 per cent all diagnosed cases. Type 2 diabetes usually develops in adults over the age of 45 and is strongly linked to lack of physical activity, obesity and family history.
Diabetes is characterised by the body’s inability to manufacture and/or effectively use insulin – a hormone that moves glucose from the bloodstream into the cells, providing the energy that they require to function properly. As you would expect, one of the key reported symptoms of diabetes is fatigue. A more insidious consequence of high blood glucose is the long term effect on many of the body’s organs.
Our eyes, with their complex network of tiny blood vessels, are particularly susceptible to damage. Every day, it is estimated that about eight Australians lose their sight as a result of diabetes-related eye diseases, the most common form of which is diabetic retinopathy. Studies have shown that 25-40 per cent of people with diabetes have some form of diabetic retinopathy at any given point in time.
Unfortunately, there are often no signs or symptoms of vision loss in the early stages of diabetic retinopathy and the only way to detect it is by having an eye examination. Once diagnosed, diabetic retinopathy can be treated and its progression slowed. Of course, the best approach is to keep blood glucose levels in the optimal range so that retinopathy is delayed or prevented altogether.
Although the National Health and Medical Research Council recommends that all people with diabetes have an eye examination upon diagnosis and every two years thereafter (more regularly for some at-risk groups and for people with existing diabetic retinopathy), it is estimated that only half of Australians with diabetes have regular eye examinations, and one third have never had their eyes checked.
There are many reasons for this troubling statistic and much work has been done to identify and address barriers including cultural, environmental, process and systemic factors, and improving education and referral pathways for health care professionals.
Work has also been done to address individual-level factors such as increasing knowledge and motivation, or targeting negative emotions associated with diabetes that might act as a barrier to self-management behaviours such as having eye examinations. The Diabetes and Eye Health study extends research by looking into the psychological and social influences on people’s decisions to seek an eye examination, with a particular focus on three groups that are considered at-risk of under-testing for diabetic retinopathy. They are younger adults (aged 18-39 years), people of Aboriginal and Torres Strait Islander origin, and people who live in rural and regional areas of Victoria.
As part of the Diabetes and Eye Health study, we plan to develop some clear communication messages, tailored to each group. They will be designed to help people understand what preventative steps they can take to reduce their risk of developing diabetic retinopathy and what steps they can take to ensure early diagnosis and treatment of the condition.
So, what’s my message to you?
If you know of someone who has diabetes, or if you are managing the condition yourself, please don’t wait until you notice changes to your vision. Make sure that you give regular eye examinations a high priority in your diabetes care and let’s reduce the risks of vision loss for people living with diabetes.
If you would like to know more about the Diabetes and Eye Health project, or other studies being conducted by The Australian Centre for Behavioural Research in Diabetes, or sign up to our newsletter, please check out our website (www.acbrd.org.au).