Spotlight on people who risk losing their sight

WHO Europe highlights the lack of effective eye screening for people with diabetes

The aims are simple: to reduce the risk of diabetes and ensure that all people who are diagnosed have access to equitable, comprehensive, affordable and quality management of their condition.

Much work remains to be done. Insulin was discovered 100 years ago, yet far too many people still are unable to access this essential, life-saving medicine.

Today, at a high-level online summit,  the World Health Organization calls for renewed action on diabetes by launching the Global Diabetes Compact, a collective effort to improve care for people with diabetes and increase service resources, particularly during the COVID-19 pandemic when services, including those for people with diabetes, are under increasing pressure.

Linked to this global event, WHO Europe is publishing the provisional results of a survey that reveals wide disparities in European countries in the provision of eye screening for people with diabetes. It is also releasing a case study about the adaptation of a diabetes care service in Portugal during the COVID-19 pandemic.

“Diabetes is a disease that continues to increase, but it is still in the shadows,”  says Dr Nino Berdzuli, Director of the Division of Country Health Programmes at WHO Europe. “Although most countries in the WHO European Region carry out eye screening for people with diabetes, opportunities to prevent blindness and vision impairment still are being missed.  People with diabetes have had their treatment greatly disrupted by the pandemic and have been at particular risk from severe disease and death from COVID-19. Health systems have found ways of coping, but diabetes care often is not included in recovery and response plans.”

Impact in Europe

Diabetic retinopathy (DR) is a leading cause of vision impairment and blindness across the WHO European Region, with an estimated 950 000 people affected. WHO Europe commissioned the University of Liverpool, United Kingdom, to carry out a situational analysis of DR screening in the WHO European Region by seeking the perspectives of ophthalmology and endocrinology professional organizations in Member States. It revealed that very few countries have good systematic DR programmes. Surveys were analysed from respondents in 45 Member States. Only six respondents reported that there was a complete list of all people with diabetes in their country that could be used to call, re-call and monitor people for eye screening regularly. Seventeen could not provide any information at all on DR screening coverage or uptake.

On 15 April, WHO Europe is also holding an online meeting for policy-makers, public health leaders and senior clinicians involved in planning, designing and implementing DR screening programmes in Georgia and Ukraine. The meeting, which is part of a larger initiative – co-funded by the Government of Denmark – that aims to improve the management of diabetes and prevent its complications in selected countries in Europe, will: review DR screening already in place; consider options available for improvement; and identify any potential quick wins over the coming months to increase effectiveness.

This work has been ongoing. In November 2020, WHO published an operational guide that demonstrates the principles and pathways for DR screening and explains how to initiate new programmes or improve the effectiveness of those already existing. The guide forms part of WHO’s efforts to increase the effectiveness of screening programmes within the Region, maximizing benefits and minimizing harm.  A Russian-language version of the guide will also be issued at the launch on 15 April.

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