A Centers for Disease Control and Prevention (CDC) study provides new insights into vision impairment (VI) prevalence over the last 20 years. The findings demonstrate that declines in VI among adults with diabetes seen in the first decade of the 2000s may have plateaued in 2012. The findings were presented at the 82nd Scientific Sessions of the American Diabetes Association^® (ADA) in New Orleans, LA.  

Diabetic retinopathy is a common and serious complication of diabetes that occurs when blood vessels in the retina are damaged by high blood glucose (blood sugar) and is the leading cause of incident blindness among working-age adults. A previous study examining the period from 1997 to 2010 found a decline in self-reported VI prevalence among adults with diabetes. This study examined whether previously reported declines in VI among adults with diabetes have continued in recent years. 

Researchers examined 20-year trends (1999–2018) in VI prevalence among adults 18 years and older with diagnosed diabetes, using self-reported data from the U.S. National Health Interview Survey with more than 52,000 respondents. Annual prevalence is presented as single years and a three-year moving average, age-standardized to the 2010 U.S. Census. Trends were analyzed using Joinpoint regression with single years of data.

The findings indicate that declines in VI among adults with diabetes seen in the first decade of the century may have plateaued in 2012. Using the three-year moving average, the prevalence of adults with diabetes who reported VI decreased from 21.5% in 1999 to 20.7% in 2018. This trend was not statistically significant (annual percent change [APC]: -0.47; p=0.2). However, Joinpoint regression found distinct trends, with VI prevalence decreasing significantly from 1999 to 2012 (21.5% to 17.7%; APC: -1.60; p<0.001) followed by an inflection point at 2012, resulting in an increase in prevalence from 2012 to 2018 that was not statistically significant (17.7% to 20.7%; APC: 3.15; p=0.2).

“While our findings of an increasing trend over the last decade did not reach statistical significance, it could be an early warning that trends in vision impairment among those with diabetes are headed in the wrong direction,” said Elizabeth Lundeen, PhD, MPH, senior scientist in the Vision Health Initiative at CDC. “Additional research will help us better understand the causes of this recent upward trend and design effective interventions to prevent vision loss in individuals with diabetes around the country.” The authors note that future research can help to confirm these trends and identify possible causes, such as changes in glycemic management, vision screening, and health care utilization. Better understanding these factors will aid in the design of sight-saving interventions.

Research presentation details:

Dr. Elizabeth Lundeen and study investigators presented the findings in a poster presentation listed below:

To increase awareness about diabetes and eye health, Focus on Diabetes™—a multi-year initiative that brings together the ADA and Visionary Partners, VSP^® Vision Care and Regeneron—provides easy steps and valuable information and experiences to help people prevent diabetes-related eye disease and preserve eyesight. 

During this year’s Scientific Sessions, Focus on Diabetes is encouraging people to attend an expert panel from the ADA and Taking Control of Your Diabetes (TCOYD). The discussion is titled “Eye Q: Increasing your understanding of diabetes and eye health,” and will be held on Sunday, June 5 at 2 p.m. CT.