12 December 2012

Rise In Diabetes Major Cause In Increase Of Visual Impairment Cases For Young People


Studies show that cases of visual impairment not due to need for glasses is significantly increasing because of the rise in type 2 diabetes.

Obesity is a major contributing factor on the rise of type 2 diabetes among young people. For the past few years, steps have been undertaken to control obesity even going as far as increasing the taxes levied on soda and sugar rich food.

Type 2 diabetes is the most common type of diabetes with 95% of diabetes cases. Obesity, physical inactivity and family history of the disease are the three prime causes of the disease. But with the prevalence of diabetes, also comes its underlying effects and consequences such as vision impairment and a weakened immune system.

Type 2 diabetes is an incurable disease where the body starts to reject its own produced insulin. Insulin is needed to control the glucose (blood sugar) levels in the body. Without insulin, complications such as hyperglycemia can occur.

Hyperglycemia can cause damage to nerves, blood vessels, and other body organs. It is associated with heart attacks and death in subjects with no coronary heart disease or history of heart failure.

There is no cure for diabetes but the condition can be managed through constant monitoring of blood sugar levels, medication, and insulin shots.

Cases of Visual Impairment in Youngsters Increase

The prevalence of nonrefractive visual impairment (not due to need for glasses) in the U.S. has increased significantly in recent years, which may be partly related to a higher prevalence of diabetes, an associated risk factor, according to a study in the December 12 issue of JAMA.

"It is estimated that more than 14 million individuals in the United States aged 12 years and older are visually impaired (~20/40). Of these cases, 11 million are attributable to refractive error. In the United States, the most common causes of nonrefractive visual impairment are age-related macular degeneration, cataract, diabetic retinopathy, glaucoma, and other retinal disorders," according to background information in the article. Previous studies have shown that visual impairment is common in persons with diabetes. "The prevalence of diagnosed diabetes has increased among adults in recent years, rising from 4.9 percent in 1990 to 6.5 percent in 1998, 7.9 percent in 2001, 10.7 percent in 2007, and 11.3 percent in 2010."


Video: Managing Diabetes If You Are Visually Impaired

Fang Ko, M.D., of the Johns Hopkins University School of Medicine, Baltimore, and colleagues conducted a study to assess the prevalence of nonrefractive visual impairment and factors associated with risk of visual impairment. The study included data from the National Health and Nutrition Examination Survey (NHANES), a representative sample of the U.S. population. In 1999-2002 and 2005-2008, 9,471 and 10,480 participants 20 years of age or older received questionnaires, laboratory tests, and physical examinations. Visual acuity of less than 20/40 aided by autorefractor (a device for measuring a person's refractive error) was classified as nonrefractive visual impairment.

The researchers found that prevalence of nonrefractive visual impairment increased 21 percent, from 1.4 percent in 1999-2002 to 1.7 percent in 2005-2008; and increased 40 percent among non-Hispanic whites 20-39 years of age, from 0.5 percent to 0.7 percent. In analysis among all participants, factors associated with nonrefractive visual impairment included older age, poverty, lower education level, and diabetes diagnosed 10 or more years ago. Among these risk factors, only the latter has increased in prevalence between the 2 time periods considered. Prevalence of diabetes with 10 or more years since diagnosis increased 22 percent overall from 2.8 percent to 3.6 percent; and 133 percent among non-Hispanic whites 20-39 years of age, from 0.3 percent to 0.7 percent.

"We report a previously unrecognized increase of visual impairment among U.S. adults that cannot be attributed to refractive error," the authors write. "If the current finding becomes a persisting trend, it could result in increasing rates of disability in the U.S. population, including greater numbers of patients with end-organ diabetic damage who would require ophthalmic care. These results have important implications for resource allocation in the debate of distribution of limited medical services and funding. Continued monitoring of visual disability and diabetes, as well as additional research addressing causes, prevention, and treatment, is warranted."

RELATED LINKS

JAMA and Archives Journals
National Health and Nutrition Examination Survey (NHANES)
Johns Hopkins University School of Medicine, Baltimore
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