Population trends in diabetic retinopathy

29 March 2017
Photo of Emma Edwards, author of the blog

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In this month's Expert series blog, RNIB Data Analyst Emma Edwards discusses the findings and implications of new research into the population trends of diabetic retinopathy.

At RNIB, we are tirelessly campaigning for the prevention of sight loss and raising awareness around eye health. One of the leading causes of blindness amongst working age people is diabetic retinopathy. It occurs when the tiny blood vessels at the back of your eye become blocked and leak but is a condition that is often preventable. Every year, 1,600 people are certified as visually impaired or severally visually impaired in England and Wales as a result of diabetic eye disease.

I have previously been involved in an evaluation of interventions to reduce health risk factors associated with developing diabetic retinopathy. For example, we know that high blood sugar levels, which can weaken blood vessels and damage the retina, can be managed by diabetic patients to prevent retinal damage from occurring. However, as a researcher, it is just as important for me to understand the population trends and demographic risk factors associated with developing the condition, along with the individual health indicators such as blood glucose levels.

Why are population trends important?

Understanding population trends in eye conditions such as diabetic retinopathy is vital in helping us to find ways to prevent more people losing their sight in the future. It gives decision makers the intelligence to put proven interventions in place where there are high risk populations.

This is why I am very excited about our new research, published in BMJ Open last month, which investigates population trends in diabetic retinopathy.

Incidence and prevalence of diabetic retinopathy

RNIB commissioned the London School of Hygiene and Tropical Medicine to conduct the largest study to date on the burden of diabetic retinopathy in the UK. It involved the analysis of millions of patient records to identify the population with diabetic retinopathy and assess relative risk factors in developing the condition.

This comes at a time when diabetes is on the rise. Currently, over 3.5 million people are diagnosed with diabetes and an estimated 1.1 million are living with undiagnosed diabetes. This study used Office for National Statistics population figures to estimate the number of people in the UK living with some form of diabetic retinopathy at 1.5 million, just over 2 in 100 people. Furthermore, 140,000 of these people are estimated to have a severe form of the condition which can include total blindness.

Risk of developing diabetic retinopathy

So, what risk factors have been identified in the study? Two important findings link the eye condition with deprivation and minority ethnic groups. The analysis found that these two factors were associated with a higher risk of severe diabetic retinopathy amongst patients with Type 2 diabetes, confirming findings from previous studies.

There was also evidence of significant regional disparities in the spread of the condition. It could be that these differences are related to variations in screening program delivery, and therefore diagnoses across the country.

These and other findings from the research have implications for professionals working in the diabetes and sight loss sectors. The evidence should inform approaches to diagnosis of retinopathy as well as campaigns to better tackle the disease for at risk groups.

Implications and innovation

Early identification of the condition and timely treatment is crucial in preventing the deterioration of sight. We know that previous research has indicated that people experiencing socio-economic deprivation tend to have poorer attendance at diabetic eye screening. This study indicates that diabetic eye screening programmes need to do more to reach out to people experiencing poverty to ensure they are able to attend and any early signs of eye disease can be detected and treated.

More positively, the study suggests that diabetic eye screening programmes have been successful in recent years. Indeed, population trends in diabetic retinopathy show the condition is no longer the leading cause of blindness among working age people in the UK. However, the evidence of significant regional disparities suggests that it is important to build on previous national work  to better plan and deliver services and ultimately reduce health inequalities.

It is also important to consider that diabetes is a complex condition for people to manage. Patients need tailored support and for care to be joined up to ensure they are equipped to effectively manage their condition and prevent complications.

It is hoped that this research can add to the body of current evidence to prevent people with diabetes from losing their sight prematurely in the future.

Go to the report

Further resources

Read the full report 'Diabetic eye disease: A UK Incidence and Prevalence Study'

Read the BMJ article 'Population trends in the 10-year incidence and prevalence of diabetic retinopathy in the UK: a cohort study in the Clinical Practice Research Datalink 2004–2014'

Visit our Knowledge and Research hub more prevention of sight loss research and service innovation