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This Evidence-Based Clinical Practice Guideline on Eye Care of the Patient with Diabetes Mellitus provides doctors of optometry with examination and management recommendations designed to preserve vision and reduce the risk of vision loss in persons with diabetes through timely diagnosis, appropriate management, and referral. The objectives of this Guideline are to assist doctors of optometry in achieving the following: • Identification of individuals at risk for diabetes • Identification of individuals with undiagnosed diabetes • Identification of individuals at risk of vision loss from diabetes • Identification of individuals in need of lifestyle management to reduce complications of diabetes • Preservation of vision by reducing the risk of vision loss in persons with diabetes through timely diagnosis, intervention, determination of need for future evaluation, and appropriate referral • Improvement in the quality of care rendered to persons with diabetes • Education of individuals and health care practitioners regarding the ocular complications of diabetes • Dissemination of information and education of individuals on the benefits of vision rehabilitation • Provision or referral for vision rehabilitation services for persons with vision loss from diabetes. 16 aoa.org II. OVERVIEW OF DIABETES MELLITUS A. DISEASE DESCRIPTION Diabetes mellitus is a chronic disease marked by high levels of blood glucose that affects both children and adults. It is a significant, costly, and potentially preventable public health problem and the seventh leading cause of death in the United States.13 The economic burden of diabetes (all ages) reached nearly $404 billion in 2017, consisting of $327.2 billion for diagnosed diabetes, $31.7 billion for undiagnosed diabetes, $43.4 billion for prediabetes, and nearly $1.8 billion for gestational diabetes.18 In addition, diabetes imposes high intangible costs on society in terms of reduced quality of life, and pain and suffering for individuals with diabetes and their families.
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