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JUNE 2015 • 9 NEW TREATMENTS SPARK OPTIMISM DR. PIZZIMENTI: Dr. Goldberg, do you have any closing remarks? DR. GOLDBERG: When I ask my patients what they fear most about having diabetes, losing vision usually tops the list. Although our methodologies are improving, diabetes prevalence is increasing. So I applaud this program, not only for bringing together multiple disciplines, but for focusing our attention on a serious problem in the management of people with diabetes. DR. PIZZIMENTI: Dr. Albini, what are your thoughts on the advances being made in treat- ments? DR. ALBINI: I think the combination of anti-VEGF and steroids and the likelihood of sustained-release anti-VEGF technologies, which I think we'll see in a few years, will bring about signifcant reductions in vision loss due to diabetic retinopathy and DME. I'm optimistic that less vision will be lost because of diabetes. DR. PIZZIMENTI: It wasn't so long ago that all we could offer patients was laser and low vision reha- bilitation. Thanks to earlier detection of diabetic retinopathy and DME and improved therapies, our patients have a much brighter outlook. DR. DUNBAR: The prevalence of diabetes is reach- ing epidemic proportions. For this reason, more and more patients are at risk of developing vision- threatening diabetic retinopathy. It's incumbent on all members of the diabetic healthcare team — including optometrists and ophthalmologists — to work together to educate and help ensure patients are seen for regular eye exams. Fortunately, there is hope for our patients as newer treatments have emerged that will allow patients to enjoy good vision for life . REFERENCES 1. Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014. http://www.cdc.gov/diabetes/pubs/statsreport14/national- diabetes-report-web.pdf. Accessed April 30, 2015. 2. Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Popul Health Metr. 2010;8:29. 3. Zhang X, Saaddine JB, Chou CF, et al. Prevalence of dia- betic retinopathy in the United States, 2005-2008. JAMA. 2010;304:649-656. 4. American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care. 2014;37 Suppl 1:S14- S80. http://care.diabetesjournals.org/content/37/Supple- ment_1/S14.full. Accessed April 1, 2015.] 5. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NID- DM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care. 1992;15:815-819. 6. Porta M, Curletto G, Cipullo D, et al. Estimating the delay between onset and diagnosis of type 2 diabetest from the time course of retinopathy prevalence. Diabetes Care. 2014;37:1668-1674. 7. Dabelea D, Mayer-Davis EJ, Saydah S, et al; SEARCH for Diabetes in Youth Study. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. 2014;311:1778-1786. 8. Center for Disease Control and Prevention. 2014 National Diabetes Statistics Report. http://www.cdc.gov/diabetes/ statistics. Accessed April 24, 2015. 9. Heintjes EM, Penning-van Beest FJA, Parasuraman SV, Grandy S, Pollack M, Herings RMC. Population attributable risk (PAR) of macrovascular events associated with HbA1c, blood pressure or weight in patients with type 2 diabetes mellitus: evidence from a Dutch cohort. Presented at: An- nual Meeting of the European Association for the Study of Diabetes; September 15, 2011; Lisbon, Portugal. 10. Margolis KL, O'Connor PJ, Morgan TM, et al. Outcomes of combined cardiovascular risk factor management strategies in type 2 diabetes: the ACCORD randomized trial. Diabetes Care. 2014;37:1721-1728. 11. Photocoagulation for diabetic macular edema. Early Treat- ment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Arch Ophthalmol. 1985;103:1796-1806. 12. Brown DM, Nguyen QD, Marcus DM, et al; RIDE and RISE Research Group. Long-term outcomes of ranibizumab therapy for diabetic macular edema: the 36-month results from two phase III trials: RISE and RIDE. Ophthalmology. 2013;120:2013-2022. continued on page 11 Please take the post test and evaluation online by going to OptometricManagementDMECE.com