World Diabetes Day brings the dangers of retinopathy into focus

Posted: 14/11/2016

World Diabetes Day 2016, which takes place on 14 November, marks the 25th anniversary of the campaign. It is led by the International Diabetes Federation (IDF) in response to growing concerns about the health threat posed by diabetes.

A new landmark study has revealed that adults with diabetes are at an unnecessary risk of vision loss and 2016’s campaign is focused on informing the public and patients about the problems and complications diabetes can cause to a person’s vision, such as diabetic retinopathy.

What is diabetes?

Diabetes is a chronic disease that occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces. Insulin is a hormone made by the pancreas, that allows glucose (sugar) from the food we eat to pass from the blood stream into the cells in the body to produce energy.

When a person develops diabetes, their inability to produce insulin can cause their blood sugar to become too high. In some cases this may be controlled through a careful diet plan, but it often requires medication and treatment. Over the long-term, high blood glucose levels are associated with damage to the body and may lead to failure of various organs and tissues. There are two types of diabetes:

• Type 1 - is usually caused by an auto-immune reaction where the body’s defence system attacks the cells that produce insulin. The reason this occurs is not fully understood. It can develop at any age, although children and young adults tend to be most vulnerable; and
• Type 2 - which is far more common and accounts for approximately 90% of all cases of diabetes. The diagnosis of type 2 diabetes can occur at any age although it may remain undetected for many years and is often diagnosed when a complication appears or a routine blood or urine glucose test is performed. It is often, but not always, associated with weight or obesity.

Complications associated with diabetes include cardiovascular disease, kidney failure, lower limb amputation and blindness. Public Health England recently reported that in 2015 3.8 million people in England were living with diabetes, of whom approximately 90% had type 2 diabetes. This may rise to over five million by 2035.

What is diabetic retinopathy?

Diabetes is the leading cause of vision impairment and blindness among working-age adults around the world. Diabetic retinopathy (or ‘retinopathy’ as it is commonly called) is a condition caused by damage to the retina (part of the eye which is crucial to a person’s sight).

For a person to be able to see, light must be able to pass from the front of the eye through to the retina at the back of the eye, while being focused by the lens. The retina then converts the light into electrical signals, which are sent via the optic nerve to the brain and converted into images. The retina needs a constant supply of blood, which it receives through a delicate network of blood vessels. Persistently high blood sugar levels can cause those blood vessels to become blocked, leaky or grow unsystematically. If the blood supply to the retina is impaired, it will be unable to work properly, and thus affect a person’s vision. If left untreated, retinopathy can lead to blindness.

It usually takes a number of years before retinopathy reaches a stage where it could threaten a person’s sight. However, over one third of people are thought to develop diabetic retinopathy during their lifetime and. worryingly, a new study has revealed that a quarter of people with diabetes are not informed by their health care professional of the risks of vision complications associated with diabetes. They are not, therefore, discussing the early signs and symptoms and only presenting when the condition has developed.

The aim of World Diabetes Day 2016 is to increase the level of education for the prevention, detection and treatment of diabetes and its associated complications in order to control and limit the risk of eye problems developing in diabetic patients. The IDF has launched a global online platform providing a source of education and certified courses on various aspects of diabetes prevention and care to help address the gaps that currently exist in the provision of quality care for people with diabetes around the world. The platform can be found at www.idfdiabeteschool.org.

Arran Macleod, an associate in the clinical negligence team at Penningtons Manches, comments: "Diabetes is a common condition which affects more and more people each year. It requires active management to be kept under control. Although it is vital that health professionals pro-actively discuss with their patients the effect diabetes may have, there seems to be a gap between health professionals’ knowledge and patients’ understanding of the condition.

“We see many clinical negligence claims arising from poor management of diabetes. Failure to discuss the risks and complications of diabetes properly may mean that conditions are not connected with the diabetes, and this may delay appropriate treatment. Sometimes this can result in loss of vision/blindness, as well as other complications, such as amputation or kidney failure.

“Treating type 2 diabetes associated complications now costs the NHS 10% of its annual budget. If the number of new diabetes diagnoses continues at its current rate, that cost could spiral upwards and could represent almost 17% of the NHS budget by 2035. It is therefore important to consider the benefits of educating patients about their condition, and the key red-flags they should look out for if symptoms start. Better educated patients should be able to have more informed conversations with their health professionals and this may result in earlier, more appropriate treatment, benefiting patients and saving NHS funds in the long-term.”

If you, a member of your family or a friend have concerns about the management of your diabetes, the specialist team at Penningtons Manches would be happy to discuss this further with you and to assess whether you have a claim for compensation.

For more information on World Diabetes Day, visit the International Diabetes Federation website.

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