Diabetes mellitus (DM) is a major medical problem in the United States and worldwide. The disease has tremendous social and economic impact as it affects individuals in their economic productive years. It is estimated that societal costs related to the disease exceed a 100 billion dollars per year. Diabetes remains a leading cause of newly diagnosed blindness in the United States and worldwide today.
The prevalence of diabetes in the United States and worldwide is clearly increasing due to variou s environmental and behavioral factors. Ten to fifteen percent of patients with diabetes have type 1 diabetes mellitus and are typically diagnosed prior to 40 years of age. The vast majority of patients are diagnosed after the age of 40 and have type 2 diabetes. Both type 1 and type 2 diabetes patients can develop ocular complications of diabetes, although patients with type 2 diabetes make up the majority of cases due to the larger patient population.
The ocular manifestations for both groups are similar however, over a long-term follow-up period. Roy et al. utilized prevalence data to estimate the prevalence of diabetic retinopathy by age, gender, and race among persons of 18 years and older having type 1 DM diagnosed before 30 years of age. It was determined that among 209 million Americans of 18 years and older, an estimated 889,000 have type 1 diabetes mellitus diagnosed before age 30 years. Among persons with type 1 diabetes mellitus, the crude prevalences of diabetic retinopathy of any level (74.9% vs. 82.3% in black and white persons, respectively) and of vision-threatening retinopathy (30.0% vs. 32.2%, respectively) are high. In another study, pooled analysis of data from eight population-based eye surveys was used to estimate the prevalence of diabetic retinopathy among adults 40 years of age and older in the United States.
Among an estimated 10.2 million adults of 40 years and older included in the study, the estimated crude prevalence rates for retinopathy and vision-threatening retinopathy were 40. and 8.2%, respectively. The estimated US general population prevalence rates for retinopathy and vision-threatening retinopathy were 3.4% (4.1 million persons) and 0.75% (899,000 persons). It is important to note that the prevalence of diabetic retinopathy in the general population has been increasing and is related to the increase in patients’ life expectancy due to better overall health care and treatment of comorbidities. Fortunately, advances in the treatment of diabetic retinopathy have allowed for improved prognosis and maintenance of visual potential in these patients.
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