THE PREVENTION AGENDA
Dec 25, 2015
The figures
• Over 263,000 people have diabetes
• 49,000 have diabetes and don’t know it
• 620,000 are at high risk
• We currently have no systematic, sustained
approach to identifying undiagnosed and at high
risk
• We have an ageing population
Three out of four blind or partially sighted older people live in poverty or less than half the mean national income
Three out of four blind or partially sighted older people live in poverty or less than half the mean national income
International research has shown a four fold return on investment in early eye care intervention
Both smoking and obesity can double the probability of sight loss. Scotland has the second highest level of obesity in the developed world [after America]. Adult smoking rates remain consistently higher in Scotland than in England and Wales.
Diabetic retinopathy is the single biggest cause of sight loss amongst Scots of working age.
People of South Asian origin are six times more likely to develop Type 2 diabetes than Caucasians. Those of African Caribbean origin are three times more likely. Some forms of glaucoma are more than three times more prevalent among people of Afro/Caribbean and Chinese descent.
The figures
• 28% have retinopathy in one or both eyes
• In 2003 this was 14.4%
• Uncertainty in the system ‘not known’ has
decreased from 34.7% to 7.6%
The figures
• However, 41,052 people are not included at
present
• 35,500 are not tested within 15 months
• Eligible population – 16-30% DNA rate [mainly
Type 1]
DNA and Type 1
• Major issue across all services but particularly
footcare and retinopathy
• The is despite the retinopathy service being rated
the highest for quality by people with diabetes
• Type 1 HbA1C - worst in Europe
• Working with the DRS and Borders Managed
Clinical Network to find out why
There are over 1,400 young people with sight loss in Scotland
Treatment - Lucentis
• Treatment for diabetic macular oedema
• Approved by SMC in 2012
• Some health boards delivering – most are not
• Cost of Lucentis is covered – but not staffing
capacity and/or training
• Have asked for clarification of delivery on this
Why the strategy is important
• Eliminate avoidable sight loss
• Pull together the factors that can lead to sight
loss – health in general, smoking, obesity
• Tackle the inequalities – employment,
deprivation, access to services
• Partnership working
• Build on the progress made so far