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Diabetes and the Canadian Optometrist

Diabetes and the Canadian Optometrist. Presented by Richard Lee BSc OD. Diabetes Mortality. Three million Canadians will be living with diabetes by the end of this decade. Diabetes contributes to the death of 41,500 Canadians each year.

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Diabetes and the Canadian Optometrist

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  1. Diabetes and the Canadian Optometrist Presented by Richard Lee BSc OD

  2. Diabetes Mortality • Three million Canadians will be living with diabetes by the end of this decade. • Diabetes contributes to the death of 41,500 Canadians each year. • Type 2 diabetes shortens life expectancy by 5-10 years.

  3. Diabetes Morbidity • Diabetes doubles the risk of stroke. • Diabetes quadruples the risk of heart disease. • Diabetes is the leading cause of non-traumatic lower extremity amputations. • Diabetes causes 33% of the new cases of end stage renal disease. • Diabetes is the leading cause of blindness in adults aged 25-75.

  4. Topics • Relations with CDA • Relations with family Physicians • Clinical Practice Guidelines • CAO position paper • Optometric research • Practice resources • Medicare coverage for diabetics • Telemedicine • Public awareness • Federal Aboriginal Projects

  5. Committee Members Dr. Garry Best Dr. Michael Dennis Dr. Richard Lee Dr. Henry Smit CAO liaison Mr. Glenn Campbell ex-officio member

  6. Diabetes Committee • Struck in October 2006 • Terms of Reference • “promote optometry’s role in the care of patients with diabetes, maintain relations with CDA at a national level, assist provincial associations and individual members in activities with CDA, promote and comment on government and stakeholder policy related to diabetes”

  7. Canadian Diabetes Association • Mission Statement • “ To promote the health of Canadians through diabetes research, education, service and advocacy.” • clinical and scientific section • diabetes educator section

  8. Canadian Diabetes Association • Charles Best forms the Diabetic Association of Toronto 1940ish • Canadian Diabetic Association 1953 • Canadian Diabetes Association 1979 • 12 Board Members • 2 Senior Vice Presidents • 7 Vice Presidents • 5 Executive Directors • 4 Field Offices • 23 Regional Offices • 150 Branches • 4 Councils • 16 Committees

  9. CDA website • the CDA website was found to be fairly well balanced in the information on eye care with the use of generic terms such as eye doctor • optometrist was not in the “diabetes dictionary” however ophthalmologist was • the CDA webmaster will be adding a definition in the new year • we suggested the CNIB definition to maintain consistent language • michael.mella@diabetes .ca

  10. CDA Publications

  11. CDA Publications

  12. CDA Publications

  13. Optometry Defined

  14. Canadian Diabetes AssociationRecommendations • appoint a provincial diabetes liaison person to meet regularly with CDA representatives ; AGM’s, CDA Expos’ • create a diabetes chat room on our CAO members website for sharing information on diabetes related matters • encourage members to support their local CDA branch by providing patients with diabetes a membership form for the CDA with the particular practice coordinates on it

  15. Clinical Practice Guidelines 2008 • commented on 4/37 chapters for external review • visual acuity should be listed as a component of the examination of the eyes • initial examination of the fundi should be performed by an optometrist or ophthalmologist and not by a family physician • we supported assessment of retinopathy through dilated pupils as the standard of care • expert professional should be clarified and replaced with “optometrist or ophthalmologist”

  16. Clinical Practice Guidelines 2008 • optometrists are listed as a referral by the PCP after an initial visit to the PCP • telemedicine is being evaluated in screening for diabetic retinopathy in communities where access to ophthalmic care is limited • CPG’s will be released in spring 2008 • possible change; if no diabetic retinopathy in people with type 2 diabetes; review 1-2 years.

  17. Retasure teleophthalmology

  18. Clinical Practice Guidelines Recommendations • make PCP’s , DE’s, peadtricians and internists aware that we are on the referral list and that we have telemedicine in our offices for photodocumentation • start preparing now for the next revision • make available to diabetes committee members a literature data base of peer reviewed journal articles on diabetes and it’s ocular effects and treatment so that we can provide evidence based statements/policies • follow developments in and studies on teleophthalmology • contact Dr. Vincent Woo to have the retinopathy section printed in the Canadian Journal of Optometry perhaps with a guest editorial

  19. Clinical and Scientific Section CDA • Executive Committee • provide a clinical perspective and feedback on current issues involving CDA • serve on committees and act as committee liaison participants in areas such as advocacy, research, camps, nutrition, clinical practice guidelines etc. • two face to face meetings per year • two to four conference calls per year • Dr. Christopher Hudson nomination

  20. Clinical and Scientific Section CDA Recommendation • re-nominate Dr. Christopher Hudson • promote membership in the C&SS of CDA to our members

  21. Diabetic Educators • diabetic educators – VIP’s • Arlene Kuntz BSP , acting chair Diabetes Educators Section • meet your educators and communicate with them regularly • The Canadian Diabetes Educator Certification Board registration with an eligible professional regulatory body worked 800 hours in diabetes education • cdecb@sympatico.ca

  22. CDA/CSEM Annual Meeting • Vancouver – October 24-27, 2007 • objectives; • meet key persons in the CDA and arrange for further communication • to make all health professionals aware of CAO’s diabetes committee • to identify opportunities for optometry to educate the 2500 attendees of optometry’s role in the care of the person with diabetes • to find out the structure of CDA

  23. CDA/CSEM Annual Meeting • key persons contacted • Mr. Garth Herbert, Chair, Board of Directors , Canadian Diabetes Association • Ms. Donna Lillie, Senior Vice President, Research, Professional Conference and Government Affairs. • Dr. Vincent Woo, Chair Clinical Practice Guidelines Review Committee

  24. CDA/CSEM Annual Meeting • recommendations; • have an optometrist present a poster in 2009 (Dec 7) • arrange a photo-op with Mr. Garth Hebert, Arlene Kuntz and Dr. Len Koltun to announce the diabetes committee and print it in the “Diabetes Communicator” which reaches the diabetic educators. • consider a CAO booth at the 2008 CDA/CSEM Annual Meeting in Montreal with retinal camera? • Alison Armstrong, Manager National Conferences alison.armstrong@diabetes.ca

  25. Medicare • New Brunswick - none • Manitoba – prn $35/$18.55 • British Columbia – 19-64yrs q6mos $44.83 • Nova Scotia -coverage • Newfoundland – • Alberta - • Saskatchewan – First Nations patients $59.55 • Ontario- • Prince Edward Island • Quebec – general coverage 17-65yrs

  26. Core Document • a work in progress • under second revision • Canadian document • complete with algorithm • highlights the optometrist’s role in the care of the person with diabetes • recommend the final draft be reviewed by an OD, PhD – Dr Christopher Hudson

  27. Closing Remarks • two prong approach; national and grass roots • communication is the key • thank-you for your confidence in our committee

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