This recent study found that people with a “near normal A1c” (<= 6%) and no detectable retina damage need only undergo the dilated eye exam every four years. This suggests a change in a long-held standard of treatment for diabetes.
It’s a short, easy to read, article. I wonder how long the clinicians will take to adapt. If you fit the profile described in this story, would you encourage your doctor to change the frequency of your eye exams?
My mom was diagnosed with diabetes because of her eye exam. Her A1c at diagnosis was only around 6 at the time.
I care about my eyes too much to not get them thoroughly checked regularly.
This is interesting.
I fit the profile and in general am for doing screenings of this sort in the most efficient way. But I am fairly freaked out about eye damage of any sort (maybe because I haven’t had any issues so far, pre- or post-diagnosis, and do not wear glasses/lenses) so in all honesty, it might take me a while to even accept the new recommended frequency, let alone go out of my way to urge my doctors to request an eye exam only once every four years…
And I wonder whether it will be independently confirmed. In the meantime, I think I’ll keep my current schedule.
My ophthalmologist did alter his approach somewhat last time, but not quite as much as they suggest. He still did a dilated eye exam, but every year since my diagnosis until now, he’d also done a complete set of retina scans. He skipped the retina scans this year, saying that he was satisfied from the visual examination that there was no change, and therefore, nothing warrant additional examination.
I don’t think I’d want to change the annual schedule, regardless. I do wear glasses and have had annual eye exams for years - no reason to stop now!
I go every six months. My doctor lets me know I can do the exam annually. I always ask to do it every six months. I ask for it because my mom lost her sight as a result of diabetes. I have seen the impact, an afternoon twice a year is a small price for prevention.
I do not have nay sign of retinopathy, I just feel better when I do this.
I have been regimented to the yearly eye exam. I’ve been doing it for decades and it’s not so burdensome to go once per year. I’ll see my eye doc in a few months. If he finds “no diabetes damage,” I may seek a two-year follow-up instead of the annual. If I encounter any eye concerns in the meantime, I could add an appointment.
By the way, I called Dexcom a few weeks ago when this Clarity graphic debuted.
This contrast sucks. Grey on white, give me a break!. 
This boomer’s 63 year-old eyeballs have to work at this. What were they thinking? Doesn’t everyone’s eyesight work as well as a 25 year-old?!!
I’ve already lodged my complaint and even received a follow-up phone call, but still no action.
I love their product, however.
When I did my Masters (in my 50s), one of the textbooks was a lighter-black/almost grey font on a yellow background! It was NOT an inexpensive textbook and totally unreadable to me. Fortunately, there was a e-book version, so I could read in in plain old black on white!
I’ll go each year as I did before my d diagnosis. My vision is not worth risking. This exam is done yearly for everyone not just pwd. I think they’re trying to cut costs so they can raise profits. My only concern would be that my regular eye Doctor who prescribes my glasses said that I have a narrow angle and it could be dangerous to dilate them too often. But he said once per year is ok. I feel with diabetes the risk is much higher for serious problems and I’m not going to wait four years etc. if you wait too long you could have severe issues.
Given that the exam is simple quick and painless I am not sure the benefits of reducing to a 3/4 year cycle are sufficient. For as start, people’s control might deteriorate over a longer period. Also, the exam will pick up other conditions that might not be directly related to diabetes, but still sight-threatening (e.g. glaucoma, cataracts).
A very sound point. Allowing incipient glaucoma to develop unobserved and undetected for 2 or for 3 years without being spotted is a bad idea indeed.
The linked article does not make a blanket recommendation to adjust everyone’s eye exam to four years. It’s recommendation offers a spectrum of exam frequency depending on the current health of the retina and the current overall blood glucose control.
The four-year recommendation is for people with no visible retina damage and an A1c of <= 6.0%, not a large cohort in my estimation.
I think this misses my point. You can have the healthiest retina on the planet and still suffer from cataracts and glaucoma, and the risk of each increases as we age. Even without considering my wife’s recent glaucoma surgery, I would never, ever go that long between exams. Others are free to do as they wish, of course.
I am not advocating that position. I’m simply acknowledging that a long-held standard of diabetes care may be changing.
I think that if your doctor and you feel comfortable with the changes and you fit those guidelines, great. One less appointment some people can cross off their list. My thinking, less can be better in the many appointments most of us have to do.
Unfortunately, many people with diabetes don’t have a1c’s in that range. I know I don’t, and I feel like I do a pretty good job with my diabetes.
And as many have stated, it has been drilled into my head that I must go in every year for a dilated eye exam, so I do. And over my many years that dreaded “you have some minor back ground bleeding” line has been spoken. But that being said, both times, it cleared up and both times was told during the follow up visits, that if he didn’t know I had diabetes for as long as I have, my visits would be pretty boring. I like boring and I will continue to go every year.
As to whether the medical professionals will get on board quickly with these guidelines, I am hoping they realize that what works for one person, doesn’t work for everyone. Like what the a1c goal should be, or how many times you should test, or you should be on a pump, or you should use a CGM or or or. You get my point. We are all different and I hope this change doesn’t effect this of us who still what to see our doctor every year and insurance might not cover it. Same fear I have with test strips and FDA approving dosing from Dexcom’s.
Correct for T1D. Only a very small proportion will have A1Cs of <6.0% and they will undoubtedly work hard to achieve it. The situation is rather different for T2s, many of whom are diagnosed with a mildly elevated A1c, put onto a diet and exercise regime, don’t take it seriously (or receive terrible education) and end up a few years later with A1c’s of >8% and taking insulin. These people are equally at risk of retinal damage.