United in our vision to save sight

Sir Michael Hirst, Persident IDF (2013-2015):

Diabetic retinopathy (DR) will become the leading cause of blindness worldwide in the next 20 years. By 2035, it is estimated that 177 million people or ⅓ of all people living with diabetes will be at risk for DR.

These troubling statistics are thrown around quite a lot. How many times have we heard about the serious and often tragic connection between diabetes and blindness? The messages are shocking, but the reality is often forgotten. Just like other hard-to-detect diabetes complications, DR can be difficult to recognise until it is too late.

How uncanny that a case of blurred vision is often the first-step before a person is even diagnosed with diabetes. When an individual finally sees a doctor, the blurred vision translates to a double diagnosis of diabetes and eye disease. These circumstances reveal just how long a person can live with undiagnosed diabetes (often more than a decade) and not know it. It also validates a global need for greater diabetes and DR awareness.

The global burden of diabetes and DR also brings to mind another important issue. Findings from the soon-to-be published Time2DoMore global survey highlight the “clinical inertia” among people with type 2 diabetes and the doctors who treat them. The survey estimates that 42 percent of people with type 2 diabetes do not reach blood glucose goals, putting them at high risk for complications, including blindness. Dr David Strain, Chairman of Time2DoMore’s Steering Committee tells us, “When people are first diagnosed they regard diabetes as a ‘mild condition’. Our data suggests the majority of people with diabetes regard complications as something that may happen in the future, and therefore not something to be concerned about in the early years.”

One of the key principles the International Diabetes Federation (IDF) will be working towards is better engagement between healthcare practitioners and people with diabetes, but that’s not all. Greater collaboration is required locally, nationally and globally among policy makers, service providers, the private sector and communities, to reduce the impact of DR.

For this very reason, The Fred Hollows Foundation and IDF formed a ten year partnership at the end of 2013. IDF’s alliance with the Foundation is the most significant initiative ever executed by IDF leadership in order to help “save sight” for millions of people with diabetes.

The Fred Hollows Foundation works throughout Asia, Africa and the Pacific as well as with Indigenous communities in Australia. A hallmark of the Foundation’s approach is working closely with partners like IDF on blindness and prevention programmes, particularly in poor and isolated regions. Our partnership will provide an opportunity to raise awareness of eye disease as a health priority.

Brian Doolan, CEO of The Fred Hollows Foundation, believes the combined efforts of IDF and the Foundation will increase the capacity to influence change. The focus of the global partnership will be advocacy, workforce development, research, programmes and technology development, and community education and awareness. Over the next ten years, IDF and Hollows will:

  • Embed DR as a health priority, and advocate for increased resources, research and global guidelines for DR prevention and care.
  • Collaborate on and roll out diabetes and eye healthcare programmes in a range of developing countries.
  •  Promote investment in innovative, cost effective technology for screening and treatment services for DR to build the capacity and extend the service reach of programmes and services.
  •  Contribute to building a skilled workforce to provide good quality care in all aspects of screening, treatment and management of the condition.

In closing, I would like to point out that this second 2014 issue of Diabetes Voice is devoted to IDF’s BRIDGES programme. As a small step forward, and to empower all people living with diabetes and eye disease, this issue has been specially formatted for the visually impaired. IDF will continue this practice for all publications in the future. The difference may seem minor, but the new format will be meaningful to people who live with diabetes and vision challenges.

I hope you will join us in advocating the right of all people living with diabetes to see the future.