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Munich, November 2024 – Diabetes mellitus and its complications are now easily treatable thanks to effective medications and therapies. Nevertheless, diabetes-related visual impairment will increase in Germany, warns Professor Dr. med. Focke Ziemssen from the DOG. In addition to demographic developments, the reasons include excessive demands on those affected, discontinuation of therapy and suppression of the disease. “We urgently need to raise awareness of the danger of impending vision loss,” demands the DOG expert on the occasion of World Diabetes Day, which takes place on November 14th.

The metabolic disease diabetes mellitus not only attacks the kidneys, feet and heart. “Over time, the fluctuating blood sugar levels also damage the fine blood vessels in the eye and impair blood flow to the nerve cells,” explains Ziemssen. As a result, small hemorrhages and protein deposits occur in the retina or an accumulation of water in the sharpest part of vision, the macula. “Up to 25 percent of those affected with type 2 diabetes develop diabetic retinopathy or diabetic maculopathy within ten years,” says Ziemssen. “These eye diseases threaten vision loss and even blindness.”

Every year 450,000 people develop diabetes

Retinopathy and maculopathy can be easily treated with lasers, injections and surgery. “Thanks to this progress, blindness as a result of diabetes has fortunately fallen significantly,” reports the DOG expert. “Nevertheless, experts worldwide expect a renewed increase in visual impairments, including in Germany,” emphasizes the retina specialist. On the one hand, this is due to demographics: type 2 diabetes is increasing – in Germany, in addition to the almost 9 million people affected, 450,000 new people become ill every year. The International Diabetes Federation (IDF) predicts that the number of patients worldwide will increase from 527 million in 2021 to 643 million in 2030.

Every second person denies having an eye disease

On the other hand, inadequate information, organizational hurdles and often a lack of awareness of the disease also play a role. This starts with early detection: Studies by major health insurance companies show that two years after the diagnosis of type 2 diabetes, only around half of all those affected have an ophthalmological examination. “Barriers cited include a lack of information and long waiting times for appointments and on the day of the examination,” says Ziemssen. Repression also plays a role. “We see again and again that those affected do not realize that they are already ill. Even among people who have undergone laser surgery, 50 percent say that they do not have retinopathy,” explains Ziemssen, who is researching this. Getting used to it and initially small, unnoticed changes promote this attitude.

Up to 60 percent stop therapy

The number of people who drop out of treatment is particularly dramatic – the discontinuation rates for injection therapy are between 30 and 60 percent during the first year of treatment. “People with diabetes often suffer from other health problems, such as their feet or kidneys,” explains the DOG expert. “You are then overwhelmed with the many doctor’s appointments, the organization of transport and the time required.” Against this background, possible blindness and its consequences are simply ignored.

Educate and empower about the urgency

In order to prevent unnecessary visual impairments, awareness of diabetes-related eye diseases must be created through increased communication. “Doctors should hand out information materials and explain the urgency of examinations and therapy,” suggests the Leipzig ophthalmologist. It is also helpful to encourage people with diabetes to ask their relatives or friends for help. “The support for transport is little compared to the impaired quality of life and the problems that arise from severe visual impairment,” states the DOG expert.

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