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Many youths with diabetes not being screened as recommended for diabetic retinopathy

March 23, 2017

Many youths with type 1 and 2 diabetes are not receiving eye examinations as recommended to monitor for diabetic retinopathy, according to a study published online by JAMA Ophthalmology.

The incidence of diabetes among children and adolescents is increasing worldwide. Diabetic retinopathy (DR) is a serious complication of diabetes that is often asymptomatic in early and occasionally later stages but may progress to sight-threatening disease. The American Academy of Ophthalmology recommends that screening for DR occur beginning at 5 years after initial diabetes diagnosis for youths with type 1 diabetes; the American Diabetes Association recommends screening of youths with type 2 diabetes at the time of initial diagnosis.

Joshua D. Stein, M.D., M.S., of the University of Michigan, Ann Arbor, and colleagues assessed the rate of obtaining ophthalmic examinations and factors associated with receipt of eye examinations for youths with diabetes. The study included individuals 21 years or younger with newly diagnosed diabetes enrolled in a U.S. managed care network.

Among 5,453 youths with type 1 diabetes (median age at initial diagnosis, 11 years) and 7,233 youths with type 2 diabetes (median age at initial diagnosis, 19 years), 65 percent of patients with type 1 diabetes and 42 percent of patients with type 2 diabetes had undergone an eye examination by six years after initial diabetes diagnosis.

Groups of youth with diabetes who had a reduced likelihood of undergoing eye examinations included racial minorities and those from less affluent families.

"Identifying ways to improve adherence to ophthalmic screening guidelines, including for racial minorities and economically disadvantaged youth, can help with timely diagnosis of DR so that sight-threatening consequences of DR can be avoided," the authors write.
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(JAMA Ophthalmol. Published online March 23, 2017.doi:10.1001/jamaophthalmol.2017.0089; this study is available pre-embargo at the For The Media website.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Related audio material: An author audio interview is available for preview on the For The Media website. The podcast will be live when the embargo lifts on the JAMA Ophthalmology website.

Related material: The commentary, "Diabetic Retinopathy Screening With Telemedicine," by Seema Garg, M.D., Ph.D., of the University of North Carolina at Chapel Hill, also is available at the For The Media website.

To place an electronic embedded link to this study in your story: Link will be live at the embargo time: http://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2017.0089

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