Ophthalmic Diabetes

This Optometric Clinical Practice Guideline for the Care of the Patient with Diabetes Mellitus is designed to provide optometrists with examination and management protocols to reduce the risks of vision loss in patients with DM through timely diagnosis and appropriate referral and intervention.

This Guideline will assist optometrists in achieving the following goals:

· Identify patients with undiagnosed DM

· Identify patients at risk of vision loss from DM

· Reduce the risk of vision loss in patients with DM through timely diagnosis and intervention

· Improve the quality of care rendered to patients with DM

· Disseminate information and continue the education of health care practitioners regarding the ocular complications of DM and the availability of vision rehabilitation programs

· Stress availability of visual rehabilitation for those with vision loss

2. A new term "IFG" (impaired fasting glucose) has been introduced to define glucose values that are greater than or equal to 110 mg/dl but less than 126 mg/dl.

3. The revised diagnostic criteria for diabetes mellitus are:

from DM through low vision devices and psychosocial support.

Although it can occur at any age, type 1 diabetes is more common in those less than 30 years of age. The rate of pancreatic destruction is variable and is generally faster in infants and children and slower in adults. Patients tend to be acutely symptomatic at onset, often complaining of polydipsia, polyphagia, polyuria, unexplained weight loss, dry mouth, pruritus, leg cramps or pains, delayed healing of skin wounds, and recurrent infections of the skin, genitalia, or urinary tract. The primary characteristic of type 1 diabetes is the absolute dependence on exogenous insulin to prevent ketoacidosis.

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