Eye examinations: the key to diabetes detection
Care & Medication The International Diabetes Federation has announced a new initiative to highlight the importance of screening to ensure early diagnosis of type two diabetes.
The ‘Eyes on Diabetes’ project will launch on World Diabetes Day (14 November) and RNIB and Specsavers, who are working together to transform the nation’s eye health, are supporting the call for greater awareness. Their backing follows joint research revealing two thirds of UK adults do not know that high street opticians can check for wider health problems. Diabetes is one such health problem.
Dr Nigel Best, Specsavers clinical spokesperson, says: ‘Screening to ensure the early detection of type two diabetes is a particular priority given the reported rise in the condition. Diabetics are 25 times more at risk of going blind than someone without the condition and early detection can be crucial in helping to prevent blindness. Regular eye examinations are also essential when it comes to detection, a full eye test today can pick up a range of indicators of diabetes.’
Leading cause of preventable sight loss
Diabetes is a leading cause of preventable sight loss in the UK. In type one, which accounts for around 10% of UK diabetics, the body's immune system destroys the cells that release insulin. Without it the cells cannot absorb sugar (glucose), which they need to produce energy. Type two, which accounts for the majority of diabetics, can develop at any age but is most common in adults. It is usually caused when the body becomes resistant to insulin, which can be due to lifestyle and diet.
Specsavers stores use their retinal cameras to detect signs of diabetes. The specialist instrument, which captures an image of the retina, can also reveal signs of diabetes, glaucoma, inflammatory disorders, age-related macular degeneration and vascular occlusions. A photographic record of your retina is retained allowing any changes which occur over time to be monitored.
The importance of eye tests for diabetics
Diabetics are at risk of developing further complications such as retinopathy, which causes damage to the retina, the seeing part of the eye. It can be identified in three main stages. Stage one, known as background retinopathy, sees bulges appear in the tiny retinal capillaries. Stage two is called pre-proliferative retinopathy and occurs when the retinal blood vessels are struggling to deliver sufficient oxygen to the retina. The final stage, proliferative retinopathy, is characterised by the formation of new blood vessels which can leak causing vision loss.
In the early stages, diabetic retinopathy will often cause no symptoms but if it progresses it can eventually lead to blindness. Early detection and management of the condition is key to preventing further damage to the eyes.
If an indicator of diabetes is identified during an eye examination, the optician will refer the patient for further tests with their GP. If diagnosed there will be healthcare support and information provided by the NHS. All those with type one and type two diabetes aged 12 or over are eligible for free annual screening as part of the National Diabetic Eye Screening Programme. Patients are referred by their GPs for this screening, which in some areas is provided by Specsavers stores.
Lifestyle changes can significantly reduce the risk of developing diabetic retinopathy for example eating a healthy, balanced diet and cutting down on salt, fat and sugar are all essential. Regular exercise can also stimulate blood flow and there is a direct link between diabetic retinopathy and obesity, so losing weight can help too.Specsavers and RNIB recommend people with diabetes have an eye examination at an opticians every at least every two years and attend for Diabetic Eye Screening annually.
In a bid to raise standards of diabetes detection, Specsavers has funded an industry-wide training course accessible for optometrists from across the industry. The qualification is free of charge and is designed to ensure that the highest level of diabetes detection is available to everyone.
Dr Best continues: ‘Diabetics can remain undiagnosed for up to 10 years, meaning it is not unusual for people to be already suffering from complications when it is first diagnosed. In fact an eye test can often be the first indicator of the disease.’
The cost of primary care prescriptions for diabetes has almost doubled in the last decade with data from NHS digital showing that approaching £1 billion was spent in England last year. The sum represents 10.6 per cent of total prescriptions issued by NHS primary care services in 2015-16.
 State of the Nation’s Eye Health, Specsavers/ RNIB 2016 www.rnib.org.uk/stateofthenation. Poll statistics are from YouGov Plc. Total sample size was 10,780 adults. Fieldwork was undertaken between 18th - 25th July 2016. The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).