Confirmation of how to counteract the onset and progression of diabetic retinopathy.
L'American Diabetes Association (ADA), a society of more than 14,000 healthcare professionals that has been providing the "standard of care" for the management of diabetic pathology, published this month the 40th volume of the Journal of Diabetes Care 2017, in order to provide recommendations that can support the Specialist in the management of diabetic pathology e improve thus the patient's quality of life. In addition, the recommendations published by the ADA were developed according to a system based on the robustness of the clinical evidence and indicated, according to the decreasing quality of the studies performed, by the letters A to E.
In particular, section no. 10 of Diabetes Care in addition to providing a general overview of the micro-vascular complications of diabetes, it provides specific recommendations for the management of the patient with diabetic retinopathy (DR), the leading cause of blindness among adults between the ages of 20 and 74. At present, as there is no fully curative drug treatment, the most effective measures to counter the onset and/or progression of DR are prevention and early diagnosis.
Several clinical evidences, in fact, have shown that periodic interventionssuch as performing comprehensive eye examinations, checking blood sugar, blood pressure and serum lipid levels can reduce the risk of DR progression (level A evidence). Individuals at risk of DR, as indicated, should also have eye examinations at a different frequency if they have type 1 or type 2 diabetes. In particular, people with type 1 diabetes should have an eye examination within 5 years of the diagnosis of diabetes (evidence B); whereas for people with type 2 diabetes, the eye examination should be performed immediately after the diagnosis of diabetic disease (evidence B).
As for the treatmentADA guidelines recommend referring patients with non-proliferating diabetic retinopathy (RDNP), proliferating diabetic retinopathy (RDP) or with macular oedema to an ophthalmologist specialised in the management of diabetic retinopathy (evidence A); while laser photocoagulation treatment is indicated to reduce the risk of vision loss for subjects at high risk of RDP, and in some cases, RDNP (evidence A). In addition, the novelty of this latest volume is the special attention paid to the pregnant women suffering from diabetic diseases for which experts have published specific recommendations.
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Dr. Carmelo Chines
Direttore responsabile
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