NIH Study Shows Eye Exam Schedule Results in Better Outcomes

By


BETHESDA, Md.—New research results may lead to a reconsideration of how often people diagnosed with type 1 diabetes should have an eye screening. The current practice recommends that type 1 diabetics (after three years of duration) schedule an annual eye screening to diagnose and/or prevent the occurrence of severe eye problems due to their diabetes.

However, the findings of a new study published April 19 by the New England Journal of Medicine could lead to changes in the once-a-year schedule for some type 1 diabetics. The findings indicate that by adjusting the frequency of eye screenings for people with type 1 diabetes based on their risk of severe eye problems, it would “result in fewer eye exams at lower cost and quicker diagnosis and treatment of advanced retinopathy,” according to a statement issued by the National Institutes of Health (NIH) here. Advanced retinopathy can lead to vision loss.

The findings are the latest from an ongoing study funded for more than 30 years by NIH, according to the statement. “The results could save money and time while getting better health outcomes—a win all around,” NIH’s Dr. Catherine Cowie said in the statement. Cowie is overseeing the Diabetes Control and Complications Trial (DCCT) and its follow-up, the Epidemiology of Diabetes Interventions and Complications (EDIC) study, at NIH’s National Institute of Diabetes and Digestive and Kidney Diseases.

“The findings from this landmark type 1 diabetes study will inform a precision medicine approach, where treatment is tailored to the individual,” Cowie added.

In its review of current and potential screening options, researchers analyzed about 24,000 retinal exams obtained over three decades from about 1,400 participants in the DCCT/EDIC trials, NIH said. “The DCCT/EDIC scientists found that people with type 1 diabetes should get eye exams to detect diabetic retinopathy based on their risk, rather than on the automatic, annual schedule that is currently recommended,” the statement added.

Several major medical groups currently recommend routine yearly eye exams, starting after three to five years of diabetes duration, for people with type 1 diabetes, according to NIH.

For people with type 1 diabetes and a current average blood glucose level of 6 percent, the researchers recommend the following eye exam schedule:

• With no retinopathy, every four years.
• With mild retinopathy, every three years.
• With moderate retinopathy, every six months.
• With severe retinopathy, every three months.

Researchers also recommended people with higher current average blood glucose levels (for example, 8 percent to 10 percent, versus 6 percent) have eye exams more often, as they are at higher risk to develop eye disease, according to NIH’s statement.

Over 20 years, the new schedule would result in eight exams on average, a greater than 50 percent reduction in eye examinations compared with annual exams, NIH estimated.