Description

This 2nd themed issue of CE Optometry is devoted to diabetes and its ocular complications. It is estimated that some 2% of the UK population have diabetes mellitus, the majority of whom have Type 2 DM (non-insulin dependent). Diabetic retinopathy remains the leading cause of visual impairment and blindness among people of working-age, yet it is widely accepted that loss of vision from this complication may be prevented if the retinopathy is detected and treated early. Studies such as the United Kingdom Prospective Diabetes Study Group (UKPDS), the Diabetes Control Complications Trial (DCCT), the Diabetic Retinopathy Study (DRS) and the Early Treatment of Diabetic Retinopathy Study (ETDRS) have established accepted guidelines for the management of diabetic retinopathy. The implementation of screening and treatment programmes for retinopathy has been shown to be cost-effective.

To open this issue we are pleased to present a guest editorial from Professor David McLeod. The subsequent CE articles by William Harvey and Mathew Raynor & George Turner address the topic of diabetic retinopathy and its treatment, while the paper by Rachel North examines how diabetes and its management affects visual function. A recently published bulletin on the complications of diabetes by the NHS Centre for Reviews and Dissemination (republished here, in part) highlights the need for screening to be efficiently organized at a local level to ensure adequate population coverage. The report suggests that there is insufficient evidence to make a specific recommendation on the best method of screening for retinopathy, but the significant role that accredited optometrists can make to this requirement is highlighted. This issue also highlights the wider contribution that optometrists and other health professionals can make to their patients with diabetes. The article by Robert Young reminds us of the wide ranging clinical complications that may occur, even in the best-regulated diabetes, and the all important role that patient education may play in reducing the disabling impact of complications. While retinopathy is rightly given pre-eminence here, the articles by Clare ODonnell and Lynn Baker serve to remind practitioners of the nature and significance of the other ocular complications associated with diabetes.