About Diabetic Retinopathy

[Ms. Kathy]

The following is an excerpt from www.priory.com/med/eye.htm

Probably the first written reference to diabetes is found in the Ebers Papyrus of ancient Egypt dating back to about 1550 BC. The disease knows no medical speciality boundaries. Diabetic retinopathy is a specific microvascular complication of both insulin dependant (type1) and non insulin dependant (type 2) diabetes. The prevalence of retinopathy is strongly linked to the duration of diabetes. After 20 years of diabetes nearly all patients with type 1 diabetes and over 60% of patients with type 2 diabetes have some degree of retinopathy. Up to a fifth of newly diagnosed diabetics have been found to have some retinopathy. A diabetic is 25 times more likely to go blind than a person in the general population.


Below is an excerpt from All About Vision.Com
Diabetic Retinopathy





By Judith Lee and Gretchyn Bailey;
reviewed by Dr. Vance Thompson

If you have diabetes, you probably know that your body can't use or store sugar properly. When your blood sugar gets too high, it can damage the blood vessels in your eyes. This damage may lead to diabetic retinopathy. In fact, the longer someone has diabetes, the more likely he is to have retinopathy.

In later stages, the disease may lead to new blood vessel growth over the retina. The new blood vessels can cause scar tissue to develop, which can pull the retina away from the back of the eye. This is known as retinal detachment, and can lead to blindness if untreated. In addition, abnormal blood vessels can grow on the iris, which can lead to glaucoma. People with diabetes are 25 times more likely to lose vision than those who are not diabetic, according to the American Academy of Ophthalmology.

Diabetic Retinopathy Symptoms and Signs
Everyone who has diabetes is at risk for developing diabetic retinopathy, but not everyone develops it. In its early stages, you may not notice any change in your vision, but it can lead to the later, sight-threatening form of the disease.


In the late stages of diabetic retinopathy, you may have blind spots and/or floaters.



Floaters can be a sign of diabetic retinopathy. Sometimes difficulty reading or doing close work can indicate that fluid is collecting in the macula, the most light-sensitive part of the retina. This fluid build-up is called macular edema. Another sign is double vision, which occurs when the nerves controlling the eye muscles are affected. If you experience any of these signs, see your eye doctor immediately. Otherwise, diabetics should see their eye doctor at least once a year for a dilated eye exam.

Your eye doctor may diagnose retinopathy using a special test called fluorescein angiography. In this test, dye is injected into the body and then gradually appears within the retina due to blood flow. Your eyecare practitioner will photograph the retina with the illuminated dye. Evaluating these pictures tells your doctor how far the disease has progressed.

Feel free to post experiences, questions, discussions, etc. about diabetic retinopathy.

[Ms. Kathy]

Diabetes patients - blindness alert
08:04am 15th June 2005
Many people with diabetes are being put at risk of unnecessary blindness because they are not receiving regular eye screening, a report has revealed.
Patients with long-term diabetes are at risk of retinopathy - a disease of the eye which is the leading cause of blindness in working age people in the UK.

But a survey of more than 1,000 diabetes patients found that 41% were either not receiving regular screening for the condition or were not being screened using a digital camera as recommended by experts.


Charity Diabetes UK has launched a report in Parliament - Diabetes and Blindness: A focus on action - in an effort to make screening more widely available.

Their survey, published during Diabetes Week, also found that 21% of people with diabetes said they had not been offered an eye examination in the past year.

Diabetes UK said at least a quarter of the tests that were carried out fell short of nationally recommended standards by not using a digital camera.

The Government has already pledged £27 million specifically to buy digital cameras and software.

But the report said that some local health services were still a long way from the target set out in the National Service Framework for diabetes in England.

This stated that by 2006 a minimum of 80% of people with diabetes were to be offered screening for the early detection and treatment of retinopathy - rising to 100% by the end of 2007.

The National Screening Committee has recommended the use of digital cameras as the most effective way of picking up retinopathy at an early stage.


Source: www.dailymail.co.uk/pages/live/articles/health/thehealthnews.html?

[Ms. Kathy]

Mon Nov 14 14:17:02 2005 Pacific Time

On World Diabetes Day, Joslin Center President Warns of Explosion in Diabetes and Its Complications
Web source: newswire.ascribe.org/cgi-bin/behold.pl?ascribeid=20051114.122957&time=14%2017%20PST&year=2005&public=0

BOSTON, Nov. 14 (AScribe Newswire) -- Today - World Diabetes Day - on the heels of new data from the U.S. Centers for Disease Control and Prevention which show an alarming 14 percent increase in the number of people with diabetes in the U.S. in the past two years alone, Joslin Diabetes Center President C. Ronald Kahn, M.D., warned of a coming "explosion" in diabetes and its complications unless action is taken to curb the mushrooming incidence of type 2 diabetes. "With the staggering increase of type 2 diabetes in younger people around the globe, my greatest nightmare is that in about 15 or 20 years, we will face an epidemic of diabetes and its complications that will be a huge burden for mankind, governments and the healthcare system," says Kahn. Already diabetes-related healthcare costs and lost productivity cost the U.S. an estimated $132 billion annually.

The World Health Organization reports that approximately 150 million people worldwide have diabetes, and the number is projected to double by the year 2025. Traditionally considered a disease of middle-aged and older adults, type 2 diabetes and the related metabolic syndrome are occurring at alarming rates in younger people. If untreated or poorly treated, diabetes can lead to blindness, kidney disease, stroke, nerve damage and circulation problems that can result in limb amputations.

"When type 2 diabetes strikes an older adult, it is serious, but it still may take 10-20 years before the individual will develop the major long-term complications like heart disease, stroke and blindness. But now that more people in their 30s, 20s and even teens are getting the disease, we will see these complications in younger and younger people," Kahn says. "I fear the ability of healthcare systems throughout the world to care for these people will be overwhelmed if we are not successful in curbing this rising tide of disease. Clearly we need to find ways to modify lifestyles, make earlier diagnosis and improve management of the disease."

- - - -

CONTACT: Marjorie Dwyer or Jenny Eriksen, Joslin Communications, 617-732-2415, [e-mail] or [e-mail]

DIABETES INFORMATION: Joslin Diabetes Center offers the public a free diabetes library on its Web site (http://www.joslin.org/) with important information in the fight against diabetes. It includes information on how to prevent type 2 diabetes in children and adults, how someone diagnosed with pre-diabetes can prevent full-blown diabetes, and how to defend against complications if diagnosed with diabetes.

For medical professionals working to stem the tide of the epidemic, Joslin posts its proven disease management guidelines on and offers continuing medical education courses across the U.S. For more information about Joslin's programs and to request an information packet on diabetes call toll-free 1-800-JOSLIN-1.

NOTE: For links to the diabetes information topics mentioned above, go to www.joslin.org/1083_3129.asp.

Media Contact: Marjorie Dwyer or Jenny Eriksen, 617-732-2415, [e-mail] or [e-mail]

[Ms. Kathy]

An eye clinic on wheels
Source: Spectrum www.deccanherald.com/deccanherald/apr112006/spectrum142132006410.asp

The Nayana project will take the mobile van to hospitals, train doctors on the latest treatment and machines and thus set up multiple centres of excellence, writes Mala Kumar.



When a big blue van topped with a satellite dish entered Arasikere, the locals were curious. In the two days that it stood at the local hospital, ophthalmologists from the local hospital teamed up with doctors from Bangalore to conduct diabetic retinopathy screenings, Flourescein Angiograms and laser eye surgeries inside the van. When patients do not come to the surgery room, the surgery room must go to the patient. That is what Vittala International Institute of Ophthalmology (VIIO) did when it initiated the ‘Nayana’ project earlier this year. The project funded by the World Diabetic Foundation includes the creation of a sustainable fully equipped mobile Diabetic Retinopathy Screening and Treatment Facilities van.

VIIO and many other organisations conduct periodic eye camps in rural areas. The diagnosis comes free. The operations too are often conducted free of charge. But surgery requires patients and their caretakers to travel long distances to a hospital, and take a week off from work. “It is sad that on an average if we see 1,500 patients during a free eye-camp, only 60-70 turn up for a follow-up visit. And only a handful come forward for treatment,” points out Dr K R Murthy, Director of VIIO. “Through the Nayana Project, we hope to reach out to the potential diabetic population of 280,000. In the three-year term of the project 12,000 diabetics will receive treatment from the mobile unit for diabetes and related vision problems of which at least 8450 people will receive the treatment free of cost.”

The vision


India’s Vision 2020 programme recognises Diabetic Retinopathy as one of the major causes of preventable blindness. According to Dr Anil Kapur, Vice Chairman, World Diabetes Foundation, there are 200 million diabetics in the world, and the number is expected to shoot up to 370-odd million in the next 25 years. India topped the list of diabetic countries, followed by China and USA. (Latest reports put China ahead of India on the list). “Diabetes does not receive enough concern from policy-makers even though the health and economic implications of diabetes are tremendous,” says Dr Kapur. Dr Kapur has initiated the development of several programmes and public awareness campaigns in diabetes as part of the Novo Nordisk Education Foundation and has presented numerous lectures on diabetes, in India and around the globe.

Adds Dr Srinivasan of Madurai’s Aravind Hospital, “Diabetes has no symptoms. Patients should start talking about retinotherapy.”

What’s Nayana project about

The Nayana Project works on the premise that every doctor wants to do his or her best for the patient. The limitations in India are usually the lack of facilities and training. Since hospitals and trained doctors already exist in most places, the project aims to take the mobile van to these hospitals, train the doctors on the latest treatment and machines and thus set up multiple centres of excellence. The project costing over Rs 1.5 crore is being executed by VIIO in association with Sri Keshava Trust and Prabha Eye Clinic & Research Centre. While the National Association for the Blind, Karnataka, will assist in community outreach, members of Karnataka Ophthalmic Society will form local treatment clusters and Cauvery Diabetic Foundation will take care of the education of general practitioners and general diabetic care. ISRO is chipping in by making satellite and video conferencing facilities available to the doctors who may want to consult VIIO’s vitreo retinal consultants.

“The two most important fields today are education and medicine,” says Dr Bhaskara Narayana, Director, SCP, ISRO. “With 150 hospitals now using the satellite facilities through ISRO, VIIO is the third eye hospital after Aravind Hospital and Shankara Nethralaya to join us.”

The dedicated mobile van gifted by Ashok Leyland has been modified to include digital slit lamps, visual fields, tonometers, frequency doubled lasers, fundus imaging cameras, basic clinical lab and communication equipment. It has already travelled to several towns. The van will be covering 70 discrete locations in eight districts of Karnataka — Hassan, Chickmagalur, Shimoga, Chitradurga, Kodagu, Koppal, Bellary and Haveri. These districts are classified as economically backward and constitute a total population of 15.2 million. A team of 70 ophthalmologists will independently manage the mobile van during its halt in each of the hospitals.

“After the initial hand-holding during the project period, the van will become self-sustaining. The doctors can jointly own the van, and conduct surgeries using the facilities in the mobile unit,” explains Dr Praveen R Murthy, Project Executive and Head-Vitreo-retinal service. “Nayana is therefore not just a project that will provide quality diabetic retinopathy treatment to people, but will also empower medical practitioners.” Apart from the 70 ophthalmologists, 100 local general practitioners will receive training in basic, intermediate and advanced diabetes management and nearly 100 other local health workers will receive training in detection, motivation and counselling of people with diabetes

Project Nayana has many benefactors including industrialist D D S Sangani. In a land where community identification is a strong motivator, people in several villages now think the blue van is their own, meant to treat their eyes! The project’s strength lies in its feasibility to be replicated.

For details contact, Vittala International Institute of Ophthalmology on 2672 2213/14/15/19.

[Ms. Kathy]

Camera may hold key to blindness
Source: Political Gateway www.politicalgateway.com/news/read/27390



GLOUCESTER, England, July 28 (UPI) -- A new camera invented by British Dr. Andy McNaughts could help adults who suffer from glaucoma or diabetes save their vision, it was reported.

The camera invented by the Gloucestershire doctor can measure the back of the retina's oxygen levels and therefore give doctors advance warning of the onset of the potentially blinding diseases, the BBC reported.

"There isn't anything like it at the moment worldwide," the Cheltenham General Hospital surgeon said. "It will be a welcome piece of equipment for ophthalmologists across the country."

The camera is a non-invasive procedure to test the eye's circulation and could offer patients a better alternative than the previous technique of injecting a fluorescent dye into the eyes.

More than 171 million people worldwide have diabetes and glaucoma is the leading cause of blindness in the world.

The camera is being tested at the Cheltenham General Hospital, which has begun using a prototype of McNaughts' invention, the BBC said.



Copyright Political Gateway 2006©
Copyright United Press International 2006
85

[Ms. Kathy]

Steroid injections 'more effective' than laser treatment
Source: www.abc.net.au/news/newsitems/200609/s1731089.htm
New research has the potential to save the sight of thousands of diabetes sufferers.

The two-year study at the Sydney Eye Hospital shows that having steroid injections into the eye is more likely to improve sight than the current laser treatment.

It is believed 15 per cent of the Australian population has diabetes, with 25 per cent of those likely to suffer loss of sight and even blindness.

The New South Wales Health Minister, John Hatzistergos, says the results demonstrate the quality of doctors and researchers working in the health system.

"The impact of this study is substantial in terms of providing hope to these patients of an improved quality of life and relieving them from the prospects of losing vision completely or partially," he said.

[Ms. Kathy]

Vision Loss Can Be Prevented in People With Diabetes
Monday October 9, 1:04 pm ET
Researchers on Verge of Developing New Pharmacological Treatments


SAN FRANCISCO, Oct. 9 /PRNewswire/ -- The millions of Americans afflicted with Type 1 and 2 Diabetes face many potential complications, including: heart and kidney disease; nerve damage and stroke; foot and skin problems; and gastrointestinal disorders and hypoglycemia.


Another major complication, affecting up to 24,000 new people per year, is permanent blindness due to diabetic retinopathy, a degenerative disease of the retina (the sensitive area at the back of the eye). Overall, diabetic retinopathy affects 5.3 million Americans 18 and older.

But there's hope. In observance of Diabetic Eye Disease Awareness Month in November, the American Academy of Ophthalmology wants Americans to know that even though diabetes is the leading cause of new cases of blindness, vision loss can be prevented if the disease is diagnosed and treated in time.

"Only 50 to 60 percent of those with diabetes get the recommended yearly eye examinations," said Jose S. Pulido, MD, Academy clinical correspondent and professor of ophthalmology at the Mayo Clinic in Rochester, Minn. "Studies show effective treatments, including an annual dilated eye exam, can reduce severe vision loss by up to 94 percent."

According to the American Diabetes Association, there are 20.8 million people in the United States, or 7 percent of the population, who have diabetes. While an estimated 14.6 million have been diagnosed, 6.2 million people (or nearly one-third) are unaware that they have the disease.

"This is a tragedy waiting to happen because people who are unaware they have the disease are at a substantially greater risk for vision loss and other complications," said Dr. Pulido. "The first step in preventing complications is finding out if you have the disease. It's important for all healthy adults over the age of 45 to have a blood sugar test once every three years."

Dr. Pulido said that the longer a person has diabetes, the greater the risk for developing diabetic retinopathy.

"Diabetic retinopathy does not only affect people who have had diabetes for many years, it can also appear within the first year or two after the onset of the disease," he said. "For some people, diabetic retinopathy is one of the first signs of the disease."

Anatomy of Diabetic Retinopathy

High blood sugar levels weaken blood vessels in the eye's retina, causing them to leak blood or fluid. This causes the retina to swell and can lead to vision loss.

Blood sugar fluctuations can also promote growth of new, fragile blood vessels on the retina, which can easily break and leak blood into the vitreous (the clear, jelly-like substance that fills the center of the eye). This can blur vision and lead to permanent blindness.

In its earliest stages diabetic retinopathy may not affect vision, but over time it can cause vision loss and even blindness in both eyes.

What are the Signs of Diabetic Retinopathy?

"Fluctuations in blood sugar levels can temporarily affect vision, so it's sometimes difficult to know if a serious eye problem is developing," said Dr. Pulido. "That's one of the reasons strict control of your blood sugar is so important. If you notice a vision change in one eye, a change that lasts more than a day or two, or changes not associated with fluctuations in blood sugar, contact your Eye M.D. immediately."


Other ways to reduce the risk of eye disease:

-- Keep your blood glucose level as close to normal as possible through
diet, exercise and, if needed, medication
-- Keep your blood pressure under control
-- Keep your cholesterol levels low
-- Don't smoke
-- Make sure your hemoglobin A1c levels (a measure of good blood sugar
control) are measured at least every four months and are less than
7.1.

Diabetic Retinopathy: A New Hope
Although incurable, diabetic retinopathy can be treated to retard its onset and progression. There's hope for the development of new pharmacological treatments that would not require invasive laser surgery. These treatments might even restore the vision that the disease destroys.

These potential treatments signal a move away from laser photocoagulation to drugs injected into the eye, as well as oral treatments.

Many of these drugs block the pathways that contribute to the vascular disruptions that characterize diabetic retinopathy. Specifically, they aim to inhibit the growth of new blood vessels or the activity of proteins in the nerve cells of the retina.

These treatments hold promise of intervention at earlier, non-sight- threatening stages, but they will require renewed emphasis on early detection. The newest and best treatments will be most effective only when the underlying disease -- diabetes -- is under control.

Free Eye Exams for Seniors

EyeCare America, a public service foundation of the American Academy of Ophthalmology, encourages diabetes patients, age 65 and older, to take advantage of its Diabetes EyeCare Program. This year-round program offers eye exams and up to one year of care at no out-of-pocket cost to qualified patients who are without an ophthalmologist.

To see if you, a loved one or a friend, is eligible to receive a referral to one of EyeCare America's 7,300 volunteer ophthalmologists, call 1-800-272- EYES (3937). The EyeCare America help lines are open 24 hours a day, every day, year round. More information on EyeCare America can be found at: www.eyecareamerica.org

About the American Academy of Ophthalmology

AAO is the world's largest association of eye physicians and surgeons -- Eye M.D.s -- with more than 27,000 members worldwide. Eye health care is provided by the three "O's" -- opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy's Web site at www.aao.org.




--------------------------------------------------------------------------------
Source: American Academy of Ophthalmology

[Ms. Kathy]

Source: American Optometric Association

Diabetes is the Leading Cause of Blindness Among Most Adults
The American Optometric Association Reminds Patients About the Importance of Comprehensive Eye Exams During November's National Diabetes Month
ST. LOUIS, Nov. 2, 2006 (PRIMEZONE) -- A recent survey by the American Optometric Association (AOA), the American Eye-Q(tm), revealed that while more than 60 percent of adults know that diabetes is detectable through a comprehensive eye exam, only 38 percent of adults who do not wear glasses or contacts have been to an eye doctor in the last two years.


Almost 21 million people in the United States have diabetes and over six million of those are undiagnosed. Additionally, an estimated 54 million Americans aged 40 to 74 have pre-diabetes, a condition that puts them at high risk for developing type 2 diabetes. Diabetes is the number one cause of acquired blindness.

Individuals who are at high risk for diabetes need to have regular, dilated eye exams and all individuals with known diabetes need to have dilated eye exams each year, according to Robert Layman, O.D. and Chair of the AOA's Diabetes Eye Care Project Team. "Individuals should consider an eye exam the first line of detection for this serious disease and its complications," said Dr. Layman. "Fortunately, in nearly all cases, diabetic retinopathy, a potentially blinding complication of diabetes and sometimes the very first sign of diabetes, can be diagnosed during a dilated eye exam in which drops are put into the eyes."

Dr. Layman adds that on many occasions, other health-threatening conditions may be discovered during an eye exam. "We can uncover unique signs that may even save someone's life. The effects of high blood pressure, anemia and elevated blood cholesterol can be seen during a dilated eye exam because the eye is the only place within the body that blood vessels can be seen in their natural state. For this very reason, Leonardo DaVinci often referred to the eye as the 'window to the body.'"

According to Michael Duenas, O.D. and health scientist at the Centers for Disease Control and Prevention (CDC), Division of Diabetes Translation, "patients suffering from diabetic retinopathy may not notice any changes in their vision, especially during the early treatable stages of the disease, this fact emphasizes the importance of all individuals with diabetes having yearly dilated eye examinations by an optometrist or ophthalmologist."

"Affordability, continuity, and regular sources of care, as well as physician advice remain core factors significantly associated with receiving this needed care," said Dr. Duenas. "There is an obvious disconnect between adults' knowledge and their actions when it comes to comprehensive eye exams," said Dr. Layman. He adds, "This is very unfortunate considering that 12,000 to 24,000 people unnecessarily lose their vision yearly because of diabetes complications that can often be prevented through early detection and timely treatment."

Key facts about diabetes:



-- More than 21 million people in the United States have diabetes.
-- 6.2 million people with diabetes are unaware they have the disease.
-- An estimated 54 million Americans aged 40 to 74 (40.1 percent of
the U.S. population in this age group) have prediabetes a condition
that puts them at high risk for developing type 2 diabetes.
-- Diabetes is the leading cause of new cases of blindness among
adults ages 20 to 74.
-- People with diabetes are 40 percent more likely to develop
glaucoma.
-- People with diabetes are 60 percent more likely to develop
cataracts.

About the American Optometric Association (AOA):

The American Optometric Association represents more than 34,000 doctors of optometry, optometry students and paraoptometric assistants and technicians. Optometrists serve patients in nearly 6,500 communities across the country, and in 3,500 of those communities are the only eye doctors.

American Optometric Association doctors of optometry are highly qualified, trained doctors on the frontline of eye and vision care who examine, diagnose, treat and manage diseases and disorders of the eye. In addition to providing eye and vision care, optometrists play a major role in a patient's overall health and well-being by detecting systemic diseases such as diabetes and hypertension. Doctors of optometry have the skills and training to provide more than two-thirds of all primary eye care in the United States.

Prior to optometry school, optometrists undergo three to four years of undergraduate study that typically culminates in a Bachelor of Science degree in a field such as biology or chemistry. Optometry school consists of four years of post-graduate, doctoral study concentrating on both the eye and systemic health. In addition to their formal training, doctors of optometry must undergo annual continuing education to stay current on the latest standards of care. For more information, visit www.aoa.org.

The American Optometric Association logo is available at www.primezone.com/newsroom/prs/?pkgid=3007

CONTACT: Hill & Knowlton
Media Contact:
Mia Sissac
[phone]
[e-mail]

[Ms. Kathy]

Article published Mar 5, 2007
Proper health-care management can reduce the complications of diabetes
By Anne Betkowski
Source Link: www.delmarvanow.com/apps/pbcs.dll/article?AID=/20070305/LIFESTYLE/703050322/1024&template=printart

What is diabetes?

Diabetes is a disease in which the body does not make or use insulin properly. Diabetes results in high blood sugar. If uncontrolled, diabetes can lead to complications. Serious complications from diabetes include: heart disease, kidney failure, blindness and amputation.

There are two main types of diabetes. Type 1 and Type 2. Pregnant women can also develop a form of diabetes, known as gestational diabetes, which can increase the chances of developing Type 2 diabetes later in life.

Complications
There are several medical complications and conditions associated with diabetes. Poorly controlled blood sugar can lead to problems with the kidneys, eyes, brain, feet, skin, teeth, nervous system and the cardiovascular system.

The risk of complications from diabetes can be reduced with proper health management. This includes following a physicians recommendations, following an appropriate eating plan, participating in regular physical activity, taking prescribed medications and monitoring blood sugar levels.

Diabetes facts you should know

Diabetes is a serious disease that can lead to blindness, heart disease, strokes, kidney failure and amputations.

Approximately 20 million people in the United States have diabetes.

Diabetes kills almost 210,000 people nationwide each year.

Approximately 277,143 people in Maryland have Diabetes -- 14.3 percent of people in Somerset, Wicomico, and Worcester counties have diabetes, almost double the U.S. rate of 8.7 percent.

Nearly 33 percent of all people with diabetes don't know they have it. Approximately 41 million people in the United States have a condition known as pre-diabetes resulting in a higher risk for circulation problems and cardiovascular disease.

Individuals with diabetes are 2 to 4 times more likely to suffer a heart attack.
Symptoms



Some people with diabetes exhibit symptoms and some do not. If you have any of the following symptoms, contact your healthcare provider:

• Extreme thirst
  
  
• Frequent urination
  
  
• Fatigue
  

Reduce your risk for heart disease and stroke
Having diabetes puts you at a much higher risk for having coronary artery disease, a heart attack, or a stroke. According to the American Diabetes Association 2 out of 3 people with diabetes die from heart disease and stroke. Even people with pre-diabetes are at an increased risk.

Lifestyle changes can help reduce your risks and help you get your target numbers under control. These changes include:

• A healthy eating plan. See a registered dietitian for help in meal planning.
  
  
• Eat less fat. Limit saturated fat and trans fats such as fatty meats, palm oil, coconut oil, hydrogenated oil and butter.
  
  
• Choose the kinds of fat that lower your cholesterol, such as olive oil, canola oil, corn oil and sunflower oil.
  
  
• Choose lean cuts of beef, poultry and pork.
  
  
• Choose low fat dairy products, such as low-fat yogurt and skim or 1 percent milk.
  
  
• Eat at least 5 servings of fruits and vegetables daily.
  
  
• Eat two to three servings of fish (like mackerel, albacore tuna, salmon, sardines, herring or rainbow trout) per week.
  
  
• Bake, roast or grill foods and avoid frying.
  
  
• Eat less salt and sodium.
  
  
• Lose weight.
  
  
• Reduce portions, calories and fat.
  
  
• Be more physically active. Talk to your health care team first. Find out if the increased activity is safe for you. Start slowly. Gradually increase the time to 30 minutes of aerobic exercise like brisk walking 5 or more days a week.
  
  
• Quit smoking.
  
  
• Take medications. You may need medications to help lower the risk of heart disease and stroke.
  
  
• Talk with your health care team and remember to go for regular check-ups.
  
  
• Ask your doctor if you should take an aspirin daily.
  Wicomico, Worcester and Somerset health departments, as well as local hospitals, offer support groups and information.
  

For more information on diabetes, call 410-543-4530 or visit www.diabetes.org.


Ann Betkowski is vice president of Healthy U of Delmarva.

[Ms. Kathy]

Diabetics warned of blindness
Source Link: www.theherald.co.uk/news/news/display.var.1259930.0.0.php
CAMERON SIMPSON and MARTIN WILLIAMS

THOUSANDS of young people with diabetes could go blind before the age of 40, a conference will be told today.

The "startling and deeply worrying" findings will be presented at the Diabetes UK Annual Professional Conference at the SECC in Glasgow. It is the UK's largest with 3000 healthcare professionals due to attend.

The delegates will hear that one in three people with Type 1 diabetes aged between 18 and 30 already has retinopathy, a complication of diabetes that can lead to blindness in later life.

Although retinopathy, a condition affecting the blood vessels supplying the retina, can be treated successfully if caught early, some of the 103 young people in the study had already reached advanced stages of the disease.

The findings raise the issue of inadequate access to retinal screening. Recent statistics showed that 26% of young people with diabetes aged between 12 and 17 have not been screened for retinopathy in the past 12 months. In Scotland it is estimated that 22% of young people were not tested for the disease.

Official government guidelines state that all young people with diabetes should receive a yearly screening from the age of 12.

The study also shows a correlation between people not attending their clinic appointments and increased risk of developing retinopathy - 54.3% of those who showed signs of the complication had a history of non-attendance.

This raises fears that the current services do not meet the specific needs of young people making them drop out'' of their diabetes clinics.

Teenagers are already more likely to find it difficult to control their blood glucose levels as the various physical changes of puberty can make them more resistant to insulin.

Poorly controlled diabetes leaves them at increased risk of developing the various complications of diabetes, including retinopathy. There are currently 2.2 million people diagnosed with diabetes in the UK. It is believed there are also 750,000 who have the condition but are unaware of it. More worryingly, the number of people developing diabetes is expected to double in the next 10-15 years.

Dr Ritesh Rampure, lead researcher, said: "The majority of the young people with eye disease had a history of poor attendance at clinics and poor blood glucose control. We need to address the issue of non-attendance to stop people from losing their sight needlessly."

Douglas Smallwood, Diabetes UK chief executive, said: "These findings are startling and deeply worrying. We have to make sure that all people with diabetes across the UK have access to digital retinal screening."

People with diabetes are advised to have an examination every year or every two years. If any significant diabetic retinopathy is found treatment may be necessary.

9:22pm Wednesday 14th March 2007

[Ms. Kathy]

Joslin Diabetes Center Reminds People with Diabetes to Schedule Annual Eye Exams to Preserve Vision Diabetes Alert Day is March 27, 2007
Source Link: www.diabeteshealth.com/read/2007/03/27/5055.html

This press release is an announcement submitted by Joslin Diabetes Center, and was not written by Diabetes Health.

BOSTON - March 23, 2007 - Did you know that diabetes is the number one cause of preventable vision loss and blindness? Did you also know that an annual eye exam can lead to early detection of diabetic retinopathy and other eye disease, a frequent complication of diabetes?

On Diabetes Alert Day, March 27 - a day set aside by the American Diabetes Association to raise public awareness of the rampant incidence of diabetes in our nation - the care team at the world renowned Joslin Diabetes Center's Beetham Eye Institute reminds the 20.8 million Americans with diabetes to schedule an annual eye exam. Joslin’s Beetham Eye Institute clinicians have shown that an annual exam can provide early detection and help prevent or delay 90 percent of cases of vision loss due to diabetic retinopathy. According to the Centers for Disease Control and Prevention, diabetic retinopathy is a leading cause of blindness in adults, resulting in 12,000 to 24,000 new cases of blindness each year.

Diabetic retinopathy, the most common eye disease in people with diabetes, occurs when the small blood vessels in the eye are damaged by high levels of glucose in the blood. Because diabetic retinopathy can progress to advanced stages without the patient knowing it, it is crucial to have annual eye exams to help preserve vision.

Joslin clinicians recommend a three-prong approach to preserving vision:

Maintain excellent A1C levels. (The A1C is a test that measures average blood glucose levels over the 2 to 3 month period before the test.)
Keep blood pressure, blood lipids and other health factors in check.
Have an annual eye exam.
To watch a video on Joslin's Web site about the importance of annual eye exams, click here: www.joslin.org/754_871.asp

For more information about eye research and clinical trials at Joslin, click here: www.joslin.org/755_3819.asp

About the Beetham Eye Institute

Joslin Diabetes Center's Beetham Eye Institute is a world leader in diabetes eye care and in research to identify the causes of diabetic eye disease and to find new therapies to lessen the risks of vision loss. The care team at the Beetham Eye Institute is dedicated to delivering the best and most personalized, compassionate care. For more information about Beetham Eye Institute services, click here: www.joslin.org/754_871.asp. For an appointment, call [phone].

[Ms. Kathy]

Successful Sight Saving Screening Programme for Diabetes Patients set to Expand
Release Date: 2007-04-22
Original Link: presszoom.com/story_129901.html
Source: Oxford Innovation

A £4.5m community based digital eye screening programme designed to detect and treat diabetic retinopathy, the leading cause of blindness in the developed world, is being rolled out to other locations, following its huge success since launching seven months ago. The Nottingham Diabetic Retinopathy Service is expanding from four to 10 locations, to include additional health centres and a branch of Boots in Nottingham City Centre as well as two hospitals. The Service has also been commended in the recently published Department of Health National Service Framework report* as a model screening programme.

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(PressZoom.com) - A £4.5m community based digital eye screening programme designed to detect and treat diabetic retinopathy, the leading cause of blindness in the developed world, is being rolled out to other locations, following its huge success since launching seven months ago. The Nottingham Diabetic Retinopathy Service is expanding from four to 10 locations, to include additional health centres and a branch of Boots in Nottingham City Centre as well as two hospitals. The Service has also been commended in the recently published Department of Health National Service Framework report* as a model screening programme.

The Nottingham Diabetic Retinopathy Service was launched ahead of schedule last September and is using OptoMize iP, an innovative digital imaging software and electronic patient records system developed by Digital Healthcare, a Cambridge company that is the UK’s leading supplier of specialist diabetic retinopathy screening software.

Diabetes patients in Nottinghamshire are invited to attend a screening clinic at a location near to their homes, where a digital photograph is taken of the back of their eyes that can detect diabetic retinopathy, a complication of diabetes that can lead to blindness if left untreated.

To date, the Service has offered nearly 11,000 screening appointments, with a current rate of 1,900 per month, to the 23,000 registered diabetes patients in Nottingham, including children from the age of 12 years. It is therefore well on track to meet Department of Health targets which require 100% of the diabetic population to have had access to a digital scan of their eyes by the end of 2007.

The Service began by screening diabetes patients at the Queen’s Medical Centre, the City Hospital, Stapleford Care Centre and Park House, Carlton. The recent extension means that patients can now also attend screening appointments at health centres in Clifton, Gamston, Ruddington, Hucknall and Kimberley as well as at the City Centre branch of Boots.

Dr Tasso Gazis, Diabetes Consultant at the Queen’s Medical Centre and Clinical Leader of the Screening Service, said: “Diabetic retinopathy is a symptomless disease that can have devastating effects but which is treatable with laser treatment if it is caught early on. The digital imaging service that we offer using Digital Healthcare’s software is the most effective way to identify the disease at an early stage. And we can also use this software to monitor for changes in eye condition by comparing images taken at different points in time.”

“Detection of the disease also depends on reaching out to diabetes patients and making it as straightforward as possible for them to attend their screening appointments. Digital Healthcare’s software can be pre-loaded onto laptops so that our staff can travel between health centres to hold screening clinics for about a month at each centre on a revolving basis. This means that we can provide a mobile, community-based service, offering patients a greater choice of locations for their screening appointments, which is particularly useful for elderly patients and increases the overall take-up rates.”

Turnaround times on the Screening Service, which is co-ordinated by the Departments of Diabetes and Ophthalmology at Nottingham University Hospitals, are rapid with patients typically receiving notification of their results within a fortnight of the screening. However, if an abnormality is detected during the screening process, the patient is referred directly to a specialist clinic for further investigation and laser treatment, if appropriate, without the need to seek a referral from their GP.

Dr Gazis commented: “The software contains a secure electronic patient records system covering all the patients on the programme so we can pull up patient histories and images instantly. The system is also fully-automated so we can generate referrals to clinics straight after screening, as well as reports on the screening results for GPs and patients. It enables just three staff members to handle nearly 80,000 items of correspondence to GPs and patients every year, so we can focus more resources on screening and grading work.”

Jeff Gordon, Chairman and Managing Director of Digital Healthcare, said: “I would like to congratulate Dr Gazis and his team on the success of the Nottingham Diabetic Retinopathy Screening Service. It is a pleasure to work with such an efficient, committed team to provide the technology that enables the Service to be a truly community-based programme which reaches out to diabetes patients.

“Diabetes currently affects 1.8 million people in the UK and that figure is expected to increase to 3m people by 2010. So it is vital that we make it as easy as possible for diabetes patients to attend digital screening appointments that could quite literally save their sight.”

David Cartwright, Director of Professional Services, Boots Opticians commented: "Boots is committed to providing access to healthcare services that make good health easier for patients. Offering this service in a high street setting means that patients can access the screening at times convenient to them."

In addition to the main Nottingham Diabetic Retinopathy Screening Service, there is a unique ‘ad hoc’ screening service at the Queen’s Medical Centre and City Hospital sites where patients from outside the region who attend a diabetes clinic are offered an eye screening appointment while they are at the hospital.

Dr Gazis concluded by commenting on future plans for the Service: “As we build up our screening records over a longer period of time, we will be able to use the software to plan treatment on an individual patient basis. For example, while we will continue to offer digital screening appointments to all diabetes patients on a regular basis, we could plan to offer even more frequent screening appointments for ‘high risk’ patients.

“The fact that Digital Healthcare’s software enables us to provide a mobile service also means that we could bring screening clinics to more locations.”

The Nottingham Diabetic Retinopathy Service is part of a national screening programme set up by the Department of Health which requires 100% of the diabetic population to have had access to a digital scan of their eyes by the end of 2007.

The Nottingham Service publishes a summary of the total number of digital screening appointments it offers at www.nottinghamretinopathy.co.uk

- ENDS -
Editors Notes
Press enquiries to Margaret Henry, PR Consultant, Digital Healthcare.
Tel: [phone] Email: [e-mail]

Photo available on request
Andy James, Screener Grader at the Queen’s Medical Centre, Nottingham, uses Digital Healthcare’s OptoMize iP software. The innovative software can detect diabetic retinopathy a disease that can cause blindness in diabetes patients.

About Digital Healthcare
Digital Healthcare was established in 2000, and is a leading producer of advanced digital imaging software and electronic patient care management systems for the healthcare market.
Digital Healthcare is the leading supplier of Ophthalmic and Diabetic Retinopathy Screening solutions to the NHS with over 100 installations in hospitals and optician practices that are used to screen over 500,000 patients every year for diseases such as glaucoma, retinopathy, cataracts and advanced macular degeneration.
Digital Healthcare provides screening solutions to over 600 private practices, hospitals and universities in the US, with satellite usage in European countries, Australasia and the Far East. Worldwide, the company’s software solutions will be screening 1 million patients by 2008. For further information: www.digital-healthcare.co.uk

*Department of Health National Service Framework report
“Improving Diabetes Services: The Way Ahead: The Local Challenge” by Dr Sue Roberts, National Clinical Director of Diabetes. A copy of the Report can be downloaded at:
www.diabetes.nhs.uk/downloads/the_way_ahead_the_local_challenge.pdf
The Nottingham Diabetic Retinopathy Service is Case Study 20 on p48.

About the Diabetes Retinal Screening Service
The Diabetes Retinal Screening Service is a national screening programme set up by the Department of Health with a target of screening 100% of the known diabetic population by the end of 2007. Digital Healthcare is one of only three companies whose software systems have been approved by the NHS Purchasing and Supply Agency (PASA) for use in the national screening programme.

Research shows that if retinopathy is identified early through retinal screening, and treated appropriately, blindness can be prevented in 90 per centre of those at risk. It has been calculated that the lifetime costs of dealing with retinopathy can be up to £237,000 per person (source: Diabetes UK Report, “The Cost of Blindness”).
Digital Healthcare’s OptoMize iP software has also been designed to comply with the National Programme for IT (NPfIT) standards for the secure electronic transmission of data (telemessaging).

Source Link: PressZoom.com - Global News Service - News and Press Release Distribution presszoom.com/story_129901.html

[Ms. Kathy]

Drug therapy for leading cause of adult blindness
Source Link: Huliq: Breaking News www.huliq.com/19706/drug-therapy-for-leading-cause-of-adult-blindness

Research increasingly shows promise to both slow and relieve the effects diabetic retinopathy, the most common complication of diabetes.

In its earliest stages, retinopathy often has no overt symptoms but can progress over time to a phase in which the blood vessels of the eye leak and rupture easily, eventually causing blindness. This frightening complication is caused by high blood glucose levels, and nearly all people with type 1 diabetes show some symptoms of the disorder.

An in-depth article in the spring 2007 edition of Countdown, the quarterly journal of the Juvenile Diabetes Research Foundation, details ongoing human clinical trials in this area, and important findings that have been made to date. In the article, JDRF-funded scientists share valuable insights into the causes of retinopathy, as well as the therapeutics that are being developed as a result of the identification of new biological targets.

One study mentioned within the article was led by Dr. Lloyd Aiello of the Joslin Diabetes Center, who showed that the compound ruboxistaurin slowed the progress of retinopathy by inhibiting an enzyme in the body called protein kinase C beta (PKC beta), which is believed to contribute to the blood vessel damage that leads to the disease. This is the first time a drug has been shown to protect against the complication in a human clinical trial.

According to Dr. Richard Insel, Executive Vice President of Research for JDRF, "Since retinopathy is the most common and serious eye-related complication of those with type 1 and type 2 diabetes – and is the leading cause of adult blindness in Americans – the outstanding research being done in this area will have a significant impact on the millions of people with diabetes." -Juvenile Diabetes Research Foundation International

[Ms. Kathy]

Migraine Sufferers Face Higher Retina Disease Risk
Source Link: NewsMax.com www.newsmax.com/archives/articles/2007/5/14/143004.shtml?s=lh
NewsMax.com Wires
Monday, May 14, 2007
WASHINGTON -- Middle-aged people with a history of migraines and other serious headaches have an increased risk for an eye disease that can lead to blindness, according to a study published on Monday.

But researchers said the headaches were not necessarily causing the 30 to 50 percent greater risk they found for retinopathy.

"What I think this suggests is that there's probably the same problem that underlies both retinopathy and the headaches where there's some dysfunction or problems in the small blood vessels in the retina and the brain," the study's lead author, Kathryn Rose of the University of North Carolina at Chapel Hill, said in a telephone interview.

Retinopathy results from damage to blood vessels of the retina, a light-sensitive layer at the back of the eye, and is more common among people with diabetes or high blood pressure.

Diabetic retinopathy is the top cause of blindness in working-age Americans. The condition causes blurriness, a loss of night vision and can progress to total vision loss if untreated.

The researchers tracked the headache history and eye health of nearly 11,000 U.S. men and women between the ages of 51 and 71. Their findings were published in the journal Neurology.

Among people in the study without diabetes or high blood pressure, the association with retinopathy was even stronger, particularly among those who had migraines and other headaches that included visual disturbances.

The researchers found that the association between these headaches and retinopathy remained even after statistically accounting for factors like diabetes, high blood pressure, use of blood pressure medications and cigarette smoking.

Migraines, a particularly painful kind of recurring headache, often are marked by dizziness, nausea, vomiting or extreme sensitivity to light and sound. Women are three times more likely than men to get migraines.

Migraines affect about 17 percent of women and 6 percent of men in the United States and are more common among younger adults and women.

Previous research has found people with a history of migraines face heightened risk of other conditions including stroke and heart attack.

© Reuters 2006.

[Ms. Kathy]

Fighting against a silent killer
Source Link: PostStar.com www.poststar.com/articles/2007/05/14/ae/today/8acd40bcb38edc7e852572db00087d13.txt

By CAROLYN POIROT
Fort Worth Star-Telegram
Monday, May 14, 2007 1:10 AM EDT

FORT WORTH, Texas -- Millions have it but don't know it.

Some lose limbs, incur blindness or develop heart disease because of it.

And millions die from it.

Diabetes is a disease in which the body either does not produce or cannot properly use insulin -- the hormone that regulates glucose, which circulates in the blood and provides energy for the human body.

An estimated 20.8 million people in the United States -- 7 percent of the total population -- now have diabetes, up from 18 million when the Centers for Disease Control and Prevention measured the prevalence in 2003. If the current rate continues, one in every three people born in 2000 will develop diabetes.

In the short-term, unregulated blood sugar starves cells of energy and usually causes excessive thirst and urination. Long-term, it damages nerves and blood vessels and can cause complications including heart disease, stroke, blindness, loss of limbs and kidney failure.

Ron Springs, 50, best known as a running back for the Dallas Cowboys in the early '80s, developed Type 2 diabetes in 1990.

Springs had several toes on his left foot and his entire right foot amputated because of staph infections. He went into kidney failure in 2004.

After three years of dialysis, Springs received a kidney transplant from his best friend and former Cowboys team mate Everson Walls on Feb. 28. "Type 2 is a very silent and very deadly disease," Spring says. "You can't ignore it."

The good news is that there are new drugs, insulin-delivery systems and medical procedures to help combat this deadly disease.

From "smart pumps" with constant glucose-monitoring to a new drug that helps diabetics lose weight as well as control their blood sugar, some folks are fighting back -- and winning.

Here are their stories.

Rebecca Wilson, 15, Grand Prairie, Texas
Photo Link: www.poststar.com/content/articles/2007/05/14/ae/today/8acd40bcb38edc7e852572db00087d13_thumb.jpg

Type 1 diabetes; uses an insulin pump and continuous glucose monitor.

Rebecca Wilson says she was clueless in July 2004 when her doctor checked her blood sugar to find out why she had no energy, was always hungry and had lost 30 pounds for no apparent reason.

Rebecca had always been healthy, never been hospitalized, never been to an emergency room and knew nothing about diabetes.

Her doctor immediately sent her to Cook Children's Medical Center in Fort Worth. There was no stopping, not even to grab breakfast at a fast-food restaurant on the way, the Grand Prairie High School freshman says.

"It really scared me. I didn't know what was going on, but when we got to the hospital, they were waiting for me and put me on IV insulin as soon as I got to the emergency room," she recalls.

Before breakfast the next morning, Dr. Paul Thornton, director of endocrinology and diabetes at Cook Children's, had Rebecca giving herself insulin injections.

By the time she began using the new insulin pump with a continuous glucose monitoring system in October, Rebecca knew all about Type 1 diabetes.

The system approved for adults about a year ago and for children in March includes a pump carried in a pocket or on a belt and a tiny electrode sensor that takes readings every five minutes to determine how much more insulin a person needs around the clock. It includes an alarm that sounds, just in case the patient isn't awake or paying attention when insulin levels get too high or too low. It helps patients take immediate and precise action to maintain healthy glucose levels and avoid any complications.

Thornton says the new continuous monitors and pumps mark a fundamental improvement in children's ability to manage their diabetes.

"It allows patients to really fine-tune their insulin needs," he says. "Normally, patients are happy to know their blood sugar is 80, but with continuous real-time monitoring, you know if it's 80 and rising, or 80 and falling, and that can be important."

Tom Wilson, Rebecca's father, says the device is invaluable.

"It has helped her a great deal. The difference between this and monitoring with finger sticks and test strips three or four times a day is like night and day," he says.

Rebecca says she loves the pump.

Musarrat Alavi, 57, Richardson, Texas

Type 2 diabetes; uses new drugs.

What Musarrat Alavi, 57, noticed first was a little numbness in her feet.

Then, she stubbed her toe and realized it was taking a long time to heal.

"I had been gaining some weight. I weighed almost 175 when Type 2 diabetes was diagnosed, almost 10 years ago," Alavi says. "I started taking Glucophage and different things my doctor prescribed and exercising and watching my diet, but nothing was helping, and I was gaining more weight."

That's when she tried Byetta, a once-a-month injectable drug that was approved in April 2005 for the treatment of Type 2

diabetes.

The first in a new class of drugs based on Gila monster saliva, which incapacitates prey by destroying its blood sugar, Byetta not only increases the life span and number of beta cells produced but also causes many patients to lose weight, according to several studies.

"I had gained up to 190 when I started taking it almost three years ago, and I started losing weight on Byetta right away. Today, I weigh 134 and have good blood sugar control," says Alavi.

She also does a lot of cardio exercise -- "whatever it takes to burn about 1,000 calories a day," she says -- but is not on a diet.

"The Byetta makes you a little nauseous when you first inject it, but you get used to it, and it makes you feel full quickly," Alavi says.

It is unclear why Byetta causes weight loss, according to the Mayo Clinic, but one effect of the drug is that it delays the movement of food from the stomach into the small intestine.

TIPS TO PREVENT DIABETES

Coffee, black pepper and even a little alcohol can help control blood sugar and stave off the development of diabetes, according to the Diabetes Survival Guide, by Dr. Stanley Mirsky, associate clinical director of metabolic diseases at the Mount Sinai School of Medicine in New York and a former president of the American Diabetes Association.

He recommends:

* Improve your diet, especially if you have a genetic susceptibility and above-normal blood sugar levels. Avoid sugar and simple carbohydrates such as sweet baked goods, white bread, regular soft drinks, large servings of pasta and some fruits, including bananas, melons and berries.

* Cut back on red meat and hot dogs, all kinds of high-fat and processed meats.

* Add coffee (four to six cups a day, according to several studies); a drink or two of beer, wine or liquor a day; spices, including pepper, cloves, bay leaves and cinnamon, magnesium (especially spinach and other leafy green vegetables, seafood and nuts); and high-fiber food, including whole-grain cereals.

* Eat fish, preferably tuna, salmon, mackerel or other cold-water varieties, or take a fish-oil supplement approved by your doctor.