Interprofessional provider communication is a crucial component to improving health outcomes in patients living with diabetes

About Jeffry Gerson, OD, FAAO

Dr. Gerson is a private practice optometrist specializing in ocular disease and low vision, having completed a residency at the Veterans Administration medical center in Kansas City and is a fellow of both the Academy of Optometry and Optometric Retina Society. He is a member of several professional associations, including the American Optometric Association (AOA) and the Kansas and Missouri optometric associations. Dr. Gerson is a frequent speaker and published author, and lectures internationally on diabetes and macular degeneration and serves as a consultant to several companies devoted to better optometric care of both diabetes and AMD.

For the more than 37 million Americans living with diabetes and the 96 million living with prediabetes, managing their conditions can often be a difficult and complicated process.

There may be concerns around diabetes stigma, negative impacts on their mental and physical health, and even worries about access to care or affordability of care needed to help manage their health. Furthermore, it can be overwhelming to learn how diabetes can increase a patient’s risk of other potentially dangerous complications like kidney disease, blindness, and nerve damage.

What’s more? Navigating the U.S. healthcare system can be confusing and time consuming. Many Americans need help getting the right information and taking the right steps to properly manage diabetes and lead healthier lives.

One of the most costly and devastating complications of diabetes can be vision loss. Weakened vessels in the retina can lead to blood and other fluid leakage and even retinal scarring and the potential for retinal detachment when let go to the extreme. If left untreated, diabetic eye diseases—like diabetic macular edema (DME) and diabetic retinopathy (DR)—can lead to vision loss and blindness. Anyone with diabetes is at risk for diabetes-related eye diseases . In fact, diabetes is the leading cause in new cases of blindness in adults aged 18–64 years and the number of individuals with diabetic retinopathy is predicted to increase by nearly 50% (to over 11 million people) by 2030.

Unfortunately, more than half of all people with diabetes don’t receive an annual dilated eye exam as recommended or are diagnosed with diabetes-related eye problems too late for effective treatment, which is often related to infrequent or no eye care.

But there is good news.

The National Eye Institute estimates that 95 percent of vision loss associated with diabetes can be prevented with an annual eye exam and appropriate followup care and treatment as needed. So, how do we help get more people living with diabetes to get eye exams?

A crucial component to improving eye health outcomes in people with diabetes is effective and ongoing communication among health care professionals including eye care professionals. Which is why the American Diabetes Association® (ADA) has partnered with several organizations to develop an Eye Care Interprofessional Communication Protocol, which can be accessed in the health care professionals resources section of diabetes.org.

The protocol is the result of months of collaboration between healthcare providers across many different disciplines including endocrinologists, primary care doctors, optometrists, nurses, and others. The protocol includes two algorithms and narrative explanations detailing the recommended processes for eye care related communications. The first algorithm focuses on appropriate referrals and eye care coordination for patients diagnosed with diabetes. The second algorithm offers guidance for eye care professionals who want to refer patients suspected to have undiagnosed diabetes or prediabetes.

Following the algorithm will provide increased diabetes and eye health education to patients; allow the care team to engage in shared decisionmaking with regard to risk reduction strategies and treatment options; and offer increased patient support for reviewing upcoming appointments or the need to make referral appointments.

This protocol has been supported by numerous organizations, associations, and government agencies, including the American Diabetes Association, the American Academy of Ophthalmology, the American Optometric Association, the American Society of Retinal Specialists, the National Eye Institute, VSP Vision™, and Regeneron.

I am grateful to have been a part of the important discussion on how to help facilitate the exchange of information among all appropriate health care professionals including eye doctors, to improve outcomes and preserve vision in people with diabetes. I hope this protocol can help save the sight of more patients living with diabetes.