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Inspiring Action, Promoting Change.
Integrated care for diabetes and eye health: A global compendium of good practice
Many of us in the eye health sector will be well familiar with the fact that Diabetic Retinopathy (DR) affects an estimated one third of all people with diabetes and is the leading cause of vision loss in working-age adults[1]. We also know that every person with diabetes is at risk of developing DR and all will potentially have it - if they live long enough. Predictions suggest that by 2040, 642 million adults will be living with diabetes, 224 million will have some form of DR and 70 million will have vision-threatening DR.[2]
If we as a sector are going to address this escalating epidemic, a coordinated and collaborative response is required. Prevention, early detection and timely treatment of DR must become an integral part of the care continuum for people with diabetes. Well-defined and effective referral pathways to specialist care will also need to be established for those who need further examination, and treatment will need to be accessible, affordable and of good quality.
To inspire action and promote change in this regard, the Global DR Advocacy Initiative have launched ‘Integrated care for diabetes and eye health: A global compendium of good practice’. This ‘first of its kind’ report documents a series of ‘real-world’ case studies that showcase initiatives to advance integrated care for DR across the spectrum of health promotion, prevention, early intervention and treatment in a range of different contexts and resource settings.
Drawing on evidence from a range of projects and programs from seventeen countries as far afield as Australia to Armenia, India to Iran, Pakistan to Peru and beyond, the document provides guidance to policy makers, medical organisations, service providers and social investors.
Included in the Compendium is a case study from our diabetic retinopathy programme titled “Diabetes eye care awareness training for primary level clinicians in Fiji.”
Funded through the Queen Elizabeth Diamond Jubilee Trust, this model has also been rolled out in five other Pacific Island Countries. The training aims to improve knowledge and skills of primary level clinicians in the area of diabetes and diabetic retinopathy prevention and management, improving referral pathways through to eye care.
With more than 422 million people globally living with diabetes today, 145 million of whom have some form of DR and 45 million of whom have vision-threatening DR[3], the scale of the challenge before us is staggering. A business as usual approach cannot prevail. We must go beyond doing more of the same isolated interventions and instead create a collective and integrated approach to address the burden of need and improve eye health outcomes for people with diabetes.
The Compendium of Good Practice has been developed by the Global Diabetic Retinopathy Advocacy Initiative - a multi-agency advocacy project undertaken by leading non-government agencies in the diabetes and eye health sectors. Participating agencies include: The Fred Hollows Foundation; Helen Keller International; The International Agency for the Prevention of Blindness; International Council of Ophthalmology; International Diabetes Federation; Lions Clubs International Foundation; Orbis International; Sightsavers International; The Queen Elizabeth Diamond Jubilee Trust; World Council of Optometry; and in association with the World Health Organisation.
The Compendium has been designed to sit alongside a range of complementary tools focused on diabetes and eye health including:
- The Joint High Level Statement on ‘Strengthening health systems to manage diabetic eye disease: Integrated care for diabetes and eye health’, by the International Council of Ophthalmology; International Diabetes Federation; World Council of Optometry and the International Agency for the Prevention of Blindness.
- The International Diabetes Federation Guide on ‘Diabetes eye health: A guide for health care professionals
- The International Council of Ophthalmology Guidelines for Diabetic Eye Care
The Compendium was launched at the 2018 IAPB Council of Members in Hyderabad, India.
For more information about the Compendium or the Global DR Advocacy Initiative, contact the Global Partnerships and Advocacy Division, The Fred Hollows Foundation: fhf@hollows.org
[1] Yau JW et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012 Mar; 35(3):556-64.
[2] IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040, https://pubmed.ncbi.nlm.nih.go...
[3] Kourgialis, N, Helen Keller International, Diabetic Retinopathy – silently blinding millions of people world wides, accessed from IAPB Vision atlas,