Systematic review of diabetic eye disease practice guidelines: more applicability, transparency and development rigor are needed

Gyawali, Rajendra; Toomey, Melinda; Stapleton, Fiona; Zangerl, Barbara; Dillon, Lisa; Ho, Kam Chun; Keay, Lisa; Alkhawajah, Sally Marwan M; Liew, Gerald; Jalbert, Isabelle

doi:10.1016/j.jclinepi.2021.08.031

Cited by 5 publications

(2 citation statements)

References 63 publications

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“…Cross-specialty communication and collaboration may be limited and not standardized; patient awareness of risk factors and compliance may be challenging [ 9 ]; and patients with DDE may have several risk factors and comorbidities [ 10 – 14 ]. Furthermore, the existence of multiple sources of information on how to manage DDE [ 8 , 10 , 15 – 22 ] and wide variation in guidelines [ 23 ] add layers of uncertainty.…”

Section: Introductionmentioning

confidence: 99%

Diabetic Disease of the Eye in Canada: Consensus Statements from a Retina Specialist Working Group

Omar,

Williams,

Whelan

et al. 2024

Ophthalmol Ther

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Despite advances in systemic care, diabetic disease of the eye (DDE) remains the leading cause of blindness worldwide. There is a critical gap of up-to-date, evidence-based guidance for ophthalmologists in Canada that includes evidence from recent randomized controlled trials. Previous guidance has not always given special consideration to applying treatments and managing DDE in the context of the healthcare system. This consensus statement aims to assist practitioners in the field by providing a spectrum of acceptable opinions on DDE treatment and management from recognized experts in the field. In compiling evidence and generating consensus, a working group of retinal specialists in Canada addressed clinical questions surrounding the four themes of disease, patient, management, and collaboration. The working group reviewed literature representing the highest level of evidence on DDE and shared their opinions on topics surrounding the epidemiology and pathophysiology of diabetic retinopathy and diabetic macular edema; diagnosis and monitoring; considerations around diabetes medication use; strategic considerations for management given systemic comorbidities, ocular comorbidities, and pregnancy; treatment goals and modalities for diabetic macular edema, non-proliferative and proliferative diabetic retinopathy, and retinal detachment; and interdisciplinary collaboration. Ultimately, this work highlighted that the retinal examination in DDE not only informs the treating ophthalmologist but can serve as a global index for disease progression across many tissues of the body. It highlighted further that DDE can be treated regardless of diabetic control, that a systemic approach to patient care will result in the best health outcomes, and prevention of visual complications requires a multidisciplinary management approach. Ophthalmologists must tailor their clinical approach to the needs and circumstances of individual patients and work within the realities of their healthcare setting. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-024-00923-0.

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Section: Introductionmentioning

confidence: 99%

Diabetic Disease of the Eye in Canada: Consensus Statements from a Retina Specialist Working Group

Omar,

Williams,

Whelan

et al. 2024

Ophthalmol Ther

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“…Diabetic ocular diseases are caused by chronic hyperglycemia in diabetic patients and include several ocular complications, including diabetic retinopathy (DR) and diabetic macular edema [1]. DR is the most common microvascular complication of diabetes and is one of the major causes of vision loss worldwide [2,3].…”

Section: Introductionmentioning

confidence: 99%

Certain Dietary Nutrients Reduce the Risk of Eye Affliction/Retinopathy in Individuals with Diabetes: National Health and Nutrition Examination Survey, 2003–2018

Zhang

Sun

Yuan

et al. 2022

IJERPH

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As the global trend of diabetes intensifies, the burden of vision-threatening retinopathy, particularly diabetic retinopathy (DR), is increasing. There is an urgent need to seek strategies for early prevention and control of DR. This study attempted to comprehensively evaluate the relationship between dietary nutrient intake and the risk of DR to provide assistance for doctors in guiding the diet of diabetic patients. Data from eligible participants with diabetes from the US National Health and Nutrition Examination Survey (NHANES) from 2003–2018 were analyzed. Univariate logistic regression was used to assess the association between 58 dietary nutrient intakes and self-reported eye disease risk. Multivariate logistic regression model was used to further evaluate the relationship between the two groups after adjusting relevant confounding factors. A total of 4595 diabetic patients were included. People with self-reported eye affliction/retinopathy had lower dietary fiber, butanoic, octanoic, vitamin A, alpha-carotene, folate, magnesium, copper and caffeine intake compared to those without self-reported eye affliction/retinopathy. The pooled ORs (95% CIs) were 0.78 (0.62–0.98), 0.79 (0.63–0.99), 0.72 (0.58–0.91), 0.74 (0.59–0.93), 0.70 (0.55–0.88), 075 (0.60–0.95), 0.79 (0.64–0.99), 0.67 (0.54–0.84) and 0.80 (0.64–0.99). Dietary cholesterol and hexadecenoic intake were higher, with the pooled ORs (95% CIs) of 1.26 (1.01–1.58) and 1.27 (1.02–1.59), respectively. Our research found that among dietary nutrients, dietary fiber, butanoic, octanoic, vitamin A, alpha-carotene, folate, magnesium, copper and caffeine intake reduced the occurrence of DR. Cholesterol and hexadecenoic intake promoted the occurrence of DR. This suggests that certain dietary nutrients should be paid more attention in the prevention of DR.

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A Dose of Reality About Dose–Response Relationships

Redelmeier,

Zipursky

2023

J GEN INTERN MED

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Systematic review of diabetic eye disease practice guidelines: more applicability, transparency and development rigor are needed

Cited by 5 publications

References 63 publications

Diabetic Disease of the Eye in Canada: Consensus Statements from a Retina Specialist Working Group

Diabetic Disease of the Eye in Canada: Consensus Statements from a Retina Specialist Working Group

Certain Dietary Nutrients Reduce the Risk of Eye Affliction/Retinopathy in Individuals with Diabetes: National Health and Nutrition Examination Survey, 2003–2018

A Dose of Reality About Dose–Response Relationships

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