#EAPM: Diabetes and blindness in India and beyond

The Brussels-based European Alliance for Personalised Medicine (EAPM) will play a key role in an international advisory board meeting of the Diabetic Retinopathy Project, on 20 October at London’s Houses of Parliament, writes European Alliance for Personalised Medicine Executive Director Denis Horgan.

The meeting comes as part of an ‘ORNATE India’ project to increase research capacity and capability to tackle the burden of blindness due to diabetes in India.

It’s a research-based approach between the UK and India.

EAPM acts as a bridge to its many stakeholders, which include high-level policymakers and funders in a multi-national context, and its executive director Denis Horgan received the invitation from Lord Patel of Bradford.

Other members of the board include Shri Keshav Desiraju, former Health Secretary, India; Rajeev Sadanandan, Health Secretary, Kerala, India; Richard Lane, ambassador and immediate past president of Diabetes UK; Rachel Connor, director of Research Partnerships, JDRF, UK, and; Dr William Summerskill, senior editor of The Lancet.

Also sitting on the board are Prof Vivekanand Jha, executive director at The George Institute for Global Health, India; Prof Peter Scanlon, director of the UK Diabetic Retinopathy Screening Programme; Prof Howard Griffiths, co-opted GCUK grant holder; Dr Vijay Viswanathan, diabetologist, Madras, Tamil Nadu; Dr Tarun Sharma,a  retinal specialist from the US, and Jill Jones, a MRC-GCRF RCUK member.

According to Christopher Brittain, senior medical director of ophthalmology clinical development at pharmaceutical giant Roche: “Vision loss affects 285 million people worldwide and the burden of visual impairment is expected to increase with both the ageing population and the diabetes epidemic.”

Diabetic eye diseases are made up of a group of eye conditions, including diabetic retinopathy, and each and every form of diabetic eye disease can cause severe vision loss and, often, blindness.

Specifically, diabetic retinopathy occurs from changes in retinal blood vessels. This can cause the vessels to bleed or leak fluid, which in turn distorts vision. Diabetic retinopathy is the most common cause of vision loss among people with diabetes.

Early detection, timely treatment, and appropriate follow-up care go a long way to protecting against loss of vision.

But diabetic eye diseases also include cataract and glaucoma. In fact, figures suggest that adults with diabetes are more likely to develop cataract than those without the disease. By no means all cataracts are caused by diabetes, of course, but those with the disease are 60% more likely to develop such eye conditions.

Diabetes sufferers often develop cataracts relatively young in life and problems progress more swiftly in such cases.

Meanwhile, diabetes sufferers are 40% more likely to suffer from glaucoma and, the longer a patient has had diabetes, the more common glaucoma is. Age, as ever, also increases risks.

Of course, most people already know that diabetes often causes problems with the eyes and that some can lead to total blindness in the worst cases. Sufferers certainly have a higher risk of developing eye problems, although disorders are usually minor. Regular check ups are advised in these cases.

Experts agree that if problems continue to develop they can usually be solved with early treatment. Once more, early diagnosis and such swift treatment prevents bigger problems down the line.

Specifically to the meeting in London, great leaps have been made recently in the treatment of diabetic retinopathy.

The faster diagnosis occurs, the greater the likelihood that treatments will succeed. In fact, it is well-worth noting that optimum results occur when the patient’s sight is still normal.

Therefore, the role of prevention cannot be over-stated.

EAPM’s invitation to the Houses of Parliament comes quickly on the back of the Alliance’s involvement in the recent launch of a White Paper entitled ‘Eyes Right: Preventable Blindness’, aimed at raising awareness of the importance of an EU focus on eye diseases.

To support a common effort on behalf of all stakeholders in this area, the White Paper, agreed by consensus, explained the need for, among other things, a more preventative approach to blindness across the EU’s Member States.

Held on 11 October, the White Paper launch was augmented by a workshop one-day ahead of year’s World Sight Day 2017, which this year operated under the banner ‘Make Vision Count’.

The White Paper is available here.

MEP Cristian Silviu Bușoi hosted the event and was joined by fellow MEPs Alojz Peterle, Marian Harkin, and Soledad Cabezon Ruiz at the launch in the Brussels seat of the European Parliament.

Topics discussed among a broad range of stakeholders focused on easing access to prevention and innovative treatments, including patients in preventable blindness policy formation, and promoting research into blindness.

Studies suggest that eye disease costs society in Europe some €20 billion, causing a significant economic burden. The number of blind people in the EU population (aged more than 50) is around 1.3 million, with in the region of a further 10 million living with medium-to-severe visual impairment.

Economic consequences of visual impairment in Europe include direct medical costs due to treatment and diagnosis, treatment of potential future health consequences (which includes an increased risk of falls or other accidents), and direct non-medical costs.

Loss of productivity due to an inability to work is also a huge factor, and this often includes the patient’s carer.

And, as Roche’s Christopher Brittain suggested, the substantial costs are more than likely to increase in the future and much better use of already-available cost-effective prevention and treatment tools would reduce the fiscal burden.

EAPM’s Denis Horgan said ahead of the upcoming London event: “Eye problems are clearly a major issue for those with diabetes. The Alliance acknowledges the work being done to tackle the huge challenges, especially in India.”

“The White Paper recently launched looks at diabetes-related eye disease, including diabetic retinopathy and, as a follow-up, EAPM is delighted to be helping to tackle such issues not only within the EU, but also at a broader international level,” Horgan added.

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