diabetes care january 2019 retinopathy guideline latest - Diabetic Retinopathy PPP 2019 American Academy diabetes mellitus typ 2 leitlinie of Ophthalmology While significant advances have been made in recent decades to preserve sight and treat vision loss in patients with diabetic retinopathy DR gaps in care coupled with a growing global diabetes epidemic make it imperative to improve existing screening and treatments say experts DR is all too common It is the leading cause of blindness Diabetic Retinopathy American Academy of Ophthalmology American Society of Retina Specialists Clinical Practice Guidelines 12 Retinopathy Neuropathy and Foot Care American Diabetes Association Diabetic retinopathy DR is common preventable and treatable with blinding consequences that affect workingaged adults making it a major focus of public health internationally 12 More than 30 million people live with diabetes in the United States according to the 2017 National Diabetes Statistics Report 3 The National Eye Institute estimates that 77 million also have DR based on Patients with diabetes have an accelerated rate of diabetic retinopathy progression during puberty and should be followed more closely Intravitreal antivascular endothelial growth factor antiVEGF agents are effective in the treatment of centerinvolved diabetic macular edema with vision loss At this time laser photocoagulation surgery Worldwide this prevalence rate has been estimated at 102 28 million people27 28 Assuming a similar prevalence of diabetes mellitus the projected prevalence of individuals with any diabetic retinopathy in the United States by the year 2020 is 6 million persons and 134 million persons will have VTDR 12 Retinopathy Neuropathy and Foot Care American Diabetes Association AAO Diabetic Retinopathy Guideline Summary Diabetic Retinopathy Screening Treatment and Trends In addition to diabetes duration factors that increase the risk of or are associated with retinopathy include chronic hyperglycemia 23 nephropathy hypertension and dyslipidemia Intensive diabetes management with the goal of achieving nearnormoglycemia has been can malnutrition cause diabetes shown in large prospective randomized studies to prevent andor delay the onset and progression of diabetic Diabetic retinopathy is a leading cause of new cases of legal blindness among workingage Americans and represents a leading cause of blindness in this age group worldwide 29 The prevalence rate for retinopathy for all adults with diabetes aged 40 and older in the United States is 285 42 million people worldwide the prevalence rate has Standards of Care in Diabetes The American Diabetes Associations ADAs Standards of Medical Care in Diabetes is updated and published annually in a supplement to the January issue of Diabetes CareThe ADAs Professional Practice Committee which includes physicians diabetes educators registered dietitians RDs and public health experts develops the Standards Standards of Medical Care in Diabetes2019 The Standards of Care in Diabetes Standards of Care includes all of current clinical practice recommendations of the American Diabetes Association ADA and is intended to provide clinicians researchers policy makers and other individuals with the components of diabetes care general treatment goals and tools to evaluate the quality of Diabetic Retinopathy Preferred Practice Pattern Ophthalmology Several case series and a controlled prospective study suggest that pregnancy in patients with type 1 diabetes may aggravate retinopathy and threaten vision especially when glycemic control is poor or retinopathy severity is advanced at the time of conception 1213Laser photocoagulation surgery can minimize the risk of vision loss during pregnancy for patients with highrisk proliferative Only about 60 of people with diabetes have recommended yearly screenings for diabetic retinopathy Referral to an ophthalmologist is required when there is any evidence of diabetic retinopathy People with type 1 diabetes should have annual screenings for diabetic retinopathy beginning 5 years after the onset of vitamin b complex diabetes their disease whereas those
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