In the latest analysis, 49% of the participants — whose average age was just 25 — developed diabetic retinopathy. While 39% had mild or very mild cases of eye disease, about 4% had its most severe form. Compared to mildly affected patients, those with severe progression had higher blood sugar and blood pressure levels, as well as more health problems.
Participants represented diverse racial and ethnic groups, including Hispanic, black, and Native American people who are considered to be at higher risk of developing type 2 diabetes, making the results generalizable to the American public, Gubitosi-Klug notes.
Treat young adults early, prevent complications
It is estimated that about 210,000 young adults in the United States under the age of 20 have diabetes, according to the American Diabetes Association. Jupitosi Kluge advises these patients to strive to tightly control their blood sugar levels and to work closely with their physicians to do so.
“Even if their vision is good now, diabetes likes to have an impact on your tissues early on, so see your doctors and follow up with an ophthalmologist,” she says. “And don’t skip these eye exams.”
In addition to the study findings on eye health, clinicians must understand that children “at an early age not only develop diabetes, but develop complications of diabetes,” Gobitossi-Kluge continues.
“I think there has been a reluctance to aggressively treat them with diabetes or high blood pressure medication because they are young. But waiting puts them on the path to developing these complications.”
She says even people without diabetes should be aware of this problem.
“We need to work with families to overcome barriers to make sure that healthy food is available to everyone, and that schools and children can focus together on healthy eating and being active to help prevent these children from developing diabetes.”
Routine eye exams should also include the additional step of dilated retinal testing, says Gubitosi-Klug. With about 1 in 10 Americans diagnosed with diabetes, and another 88 million with prediabetes, this test can detect early signs of diabetic retinopathy or other serious vision changes.
“There’s good news: If we detect early lesions and improve diabetes control, we know from other studies that some eye outcomes can improve,” she says. “Therefore, there is always a benefit in trying to improve your diabetes management.”