Editor’s Blog: Forget the future, diabetes is an epidemic now

As part of Ophthalmology Times’ coverage of the 14th EURETINA Congress in London this week, Group Content Director Mark L. Dlugoss writes this blog.

London-Despite the growing numbers of patients who have presented with various diabetic retinal diseases, ophthalmology is only one segment of a much larger and growing problem in the world. Statistics in regard to the prevalence of diabetes are staggering, and the impact of the disease has reached epidemic proportions-and those statistics are only going to get worse.

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During the 14th EURETINA Congress in London this week, Bayer Healthcare held a media briefing to present the 2-year results from the phase III VIVID-DME trial of aflibercept injection (Eylea, Bayer/Regeneron) to the European ophthalmic community. While the briefing presented positive results for aflibercept in the treatment of diabetic macular edema (DME), the session also provided discussion about the ramifications of diabetes beyond retinal diseases.

Staggering statistics

Marc Evans, MD, a consultant “diabetologist” at Llandough Hospital and the University Hospital of Wales, UK, presented an overview of diabetes that included the complications of the disease and the social and economic burdens that diabetes will incur worldwide.

Diabetes is projected to grow worldwide from 382 million people today to 592 million by the year 2035-that is an increase of 55%. About 46% of people with diabetes are undiagnosed and unaware of the long-term damage the disease presents to their bodies.

Only the tip of the iceberg

Retinal disease associated with diabetes is only the tip of the iceberg of potential medical complications. There is cerebrovascular disease (brain and cerebral circulation), oral health, heart and coronary circulation, nephropathy, peripheral vascular disorders (lower limbs), neuropathy (peripheral nervous system), and diabetic foot (ulceration and amputation) complications. About 33% of people with diabetes develop related eye damage or blindness.

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The financial burden presented by diabetes is an epidemic in itself. According to a report published in 2012 in Diabetic Medicine, the National Health Service’s (NHS) annual spending on diabetes in the UK was projected to increase from £9.8 billion to £16.9 billion over the next 25 years. This means that NHS would spend 17% of its entire budget on diabetes in the future.

Another report suggests that the cost of treating diabetes complications is expected nearly to double from the current total of £7.7 billion to £13.5 billion by 2035. Dr. Evans says that 80% of costs from diabetes are associated with its complications.

Impact on world economy

Besides increased medical costs, diabetes also imposes a substantial burden on the world economy in the form of indirect costs from work-related absenteeism, reduced productivity, reduced labor force from chronic disability, and premature mortality. Diabetes imposes high intangible costs on society in terms of reduced quality of life and pain and suffering for patients with diabetes and their families.

Projections for the United States are not much better. The estimated total economic cost of diagnosed diabetes in 2012 was $245 billion. That was a 41% increase from the previous estimate of $174 billion in 2007. Do the math and the financial burden associated with diabetes for 2035 will more than likely fall in line with the rest of the world.

Ophthalmology’s role in the fight

This is not a pretty picture. No matter how one looks at diabetes-medically, economically, or socially-it is, and will be a mess.

If there were possible caveats to drawn from this discussion, one would be Dr. Evans’ assessment of eye diseases. Ophthalmology-with its research and development of drugs to treat diabetic-related eye disease-is offering some hope for patients.

Ophthalmology still has a long way to go in its fight with diabetic eye disease.