ABSTRACT
This paper identifies best practice recommendations for managing diabetes and sight-threatening diabetic eye disease. The authors provide an update for ophthalmologists and allied healthcare professionals on key aspects of diabetes management, supported by a review of the pertinent literature, and recommend practice principles for optimal patient management in treating visual impairment due to diabetic eye disease. In people with diabetes, early optimal glycaemic control reduces the long-term risk of both microvascular and macrovascular complications. The authors propose more can and should be done to maximise metabolic control, promote appropriate behavioural modifications and encourage timely treatment intensification when indicated to ameliorate diabetes-related complications. All people with diabetes should be screened for sight-threatening diabetic retinopathy promptly and regularly. It is shown that attitudes towards treatment adherence in diabetic macular oedema appear to mirror patients' views and health behaviours towards the management of their own diabetes. Awareness of diabetic macular oedema remains low among people with diabetes, who need access to education early in their disease about how to manage their diabetes to delay progression and possibly avoid eye-related complications. Ophthalmologists and allied healthcare professionals play a vital role in multidisciplinary diabetes management and establishment of dedicated diabetic macular oedema clinics is proposed. A broader understanding of the role of the diabetes specialist nurse may strengthen the case for comprehensive integrated care in ophthalmic practice. The recommendations are based on round table presentations and discussions held in London, UK, September 2016.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Diabetic Retinopathy/therapy , Glucocorticoids/therapeutic use , Laser Coagulation , Macular Edema/therapy , Vision Disorders/prevention & control , Vitrectomy , Blood Glucose/metabolism , Diabetes Mellitus/epidemiology , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/epidemiology , Diagnostic Techniques, Ophthalmological , Disease Management , Glycated Hemoglobin/metabolism , Glycemic Index , Humans , Macular Edema/diagnosis , Macular Edema/epidemiology , Nurse Specialists , Patient-Centered Care , Prevalence , United Kingdom/epidemiology , Visually Impaired PersonsABSTRACT
The drinking habits of children aged 11 to 16 years attending a comprehensive school are reported. Pupils were able to access alcoholic drinks readily despite being underage. A general awareness of the health and social risks of drinking did not act as a deterrent and, alarmingly, only less than 10% of the group reported that they did not drink. Health education and the role that schools can play are highlighted.
