Do People with Diabetes Avoid Diabetic Eye Exams?

The first line of defense for providers to help people manage their diabetes is often during routine visits at the point-of-care. Regular diabetes exams help people with diabetes address symptoms and avoid potentially damaging outcomes, while focusing on behavior management and overall psychological well-being. 

But what if a person living with diabetes is not following up with their diabetes care management plan when they should? 

Why do patients avoid visiting the doctor? 

People often avoid visiting a doctor unless they have noticeable symptoms of illness. Even people living with progressive medical conditions, such as diabetes, fall into this category. Studies indicate 12% of the overall American population avoids medical care out of a low perceived need for it.1 

Compound that statistic with 36% of Americans who avoid seeking care even if they suspect they should see a doctor.2 These avoidances could be linked to psychological stress and the desire to avoid a potential disease diagnosis or possible negative outcome. 

Add that the stresses and weight of a possible diagnosis to busy schedules, forgetfulness, procrastination, and lack of access, and you have a population that is at higher risk for delayed diagnosis and care. The specific danger these delays present for people living with diabetes can be devastating in many ways, including the development and acceleration of diabetic retinopathy (including macular edema) leading to an increased need for medical intervention and the potential for increased financial strain. 

The good news for point-of-care physicians is that it is possible to influence patient outcomes and change the system to benefit people with diabetes. 

People with diabetes often skip annual diabetic eye exams 

60,000 people in the United State with diabetes develop diabetic retinopathy each year.3 This disease can eventually lead to blurry vision, visual loss, and even blindness when left undiagnosed and untreated. Blindness is the number one fear for people with diabetes according to patient data.4 Loss of sight can impact quality of life, require dependency on others, and endanger financial security. Yet, despite their fear, almost half of people with type 2 diabetes had no eye exams over a five-year period, while a third of people with type 1 diabetes missed their exam. 

People with diabetes are more likely to notice obvious chronic health condition symptoms such as sores, infections, or nerve pain. Eye issues, however, rarely present noticeable symptoms until it is too late to avoid complications and irreversible damage has occurred. 

When symptoms do begin, they may be mild and are easy to write off as exhaustion. Based on the above statistics of care avoidance, people with diabetes may not pursue immediate physician consultation even if they do notice something is out of the ordinary with their vision. 

Symptoms of diabetic retinopathy (including macular edema) include: 

  • Blurred vision 
  • Vision that blurs, then improves, only to worsen again 
  • Seeing spots 
  • Eye pain 
  • Sudden loss of vision 

Many of those symptoms may be minimized by a patient as a temporary nuisance or general illness. If they do not set a follow up appointment with their eye doctor, they risk a worsening condition with outcomes potentially leading to further complications or blindness. 

What can providers do to catch diabetic retinopathy (including macular edema) progression early, despite patient tendency to avoid follow up care? 

AI diagnostic care for diabetic retinopathy (including macular edema) 

What if you could help your patients identify more than mild diabetic retinopathy (including macular edema) in your office? And what if it only took a handful of minutes (the amount of time it takes to generate a referral)? You could immediately address the issue of patients who do not schedule their follow up eye exam and help to halt diabetic retinopathy (including macular edema) progression early. 

New healthcare advances benefit from the use of artificial intelligence (AI) to accurately identify diabetic retinopathy at the point-of-care. These diagnostic tools allow a physician’s office to generate a positive or negative test result for more than mild diabetic retinopathy (including macular edema). That means a patient can leave their appointment knowing either they are negative for disease and simply need to be retested in a year, or they received a positive result for disease and an urgent visit to an eye care specialist is needed. 

AI technology as a diagnostic tool offers this capability. The benefits to your patients and your practice are many: 

  • Examine patients for diabetic retinopathy (including macular edema) when they are in your office 
  • Easy to use with minimal workflow changes 
  • Results at the point-of-care 
  • No need for specialist overread or telemedicine callbacks 
  • Identify patients in need of immediate eye care 
  • Process often covered by insurance 

Influence eye care management from the source 

People with diabetes rely on care providers to help navigate their health condition. Adopting technology to make patient care more streamlined and inclusive helps patients avoid visual loss and blindness. Providing diabetic retinopathy (including macular edema) diagnostic exams in your office ensures patients receive the care they need when they need it.  

As a clinician guiding diabetes care, you have the power to influence positive health outcomes. Diagnose diabetic retinopathy (including macular edema) sooner using cutting edge tools like AI diagnosis, and you can help your patients with diabetes avoid their greatest fear. 

Learn more about IDx-DR, the first AI diagnostic system for use at the point-of-care that autonomously analyzes images of the retina for signs of diabetic retinopathy (including macular edema). 

Looking for more topics like this one? Read “What Your Patients Can Expect During a Diabetic Retinopathy Exam.” 

 

References: 

  1. Taber, J et al (2015). Why do people avoid medical care? A qualitative study using national data. J Gen Intern Med. 2015 Mar; 30(3): 290-297. Accessed online Sept. 10, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351276/ 
  2. Ye, J et al (2014). Health care avoidance among people with serious psychological distress: Analyses of 2007 health information national trends survey. J Health Care Poor Underserved. 2012 Nov; 23(4): 1620 – 1629. Accessed online Sept. 10, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039298/ 
  3. Varma, R., et al (2016). Visual Impairment and Blindness in Adults in the United States. JAMA Ophthalmology, 134(7), 802. doi:10.1001/jamaophthalmol.2016.1284 
  4. Savage, Sam (2006). U.S. Adults with diabetes fear blindness or vision loss more than premature death. Red Orbit, Health. Accessed online Sept. 14, 2020. https://www.redorbit.com/news/health/757152/us_adults_with_diabetes_fear_blindness_or_vision_loss_more/ 
  5. Benoit, S. R., et al (2019). Eye care utilization among insured people with diabetes in the U.S., 2010–2014. Diabetes Care, 42(3), 427-433. doi:10.2337/dc18-0828 
  6. WebMD (2019). A closer look at diabetic retinopathy. WebMD online. Accessed Sept 14, 2020. https://www.webmd.com/diabetes/closer-look-diabetic-retinopathy