15
EW NEWS & OPINION
August 2018
4. Ask your local low vision
clinic about resources that can
help patients with diabetes. This
can be important for patients with
diabetes who have markedly im-
paired vision due to eye disease or
during a postop recovery period. "If
they can't accurately dose insu-
lin due to decreased visual acuity,
they risk hyper- or hypoglycemia,"
Dr. Halprin said. "They may need
additional tools for monitoring and
dosing. Employees at low vision
clinics should be aware of talking
blood glucose meters that provide
audio for patients instead of requir-
ing patients to read numbers on a
small screen. Additionally, there
are magnifiers for insulin pens and
syringes to help with proper dosing,
Dr. Halprin said.
5. Have a working knowledge
about newer diabetes technol-
ogy and medications. Just like
treatments for diabetic eye disease
continue to improve, treatments to
help control blood sugar continue
to flourish. "The use of technology
such as continuous glucose moni-
toring systems and insulin pumps,
along with other non-insulin oral
and injectable medications, have
revolutionized care for patients with
diabetes in 2018," Dr. Miller said.
The newer pumps and monitors
often allow for tighter blood sugar
control.
"Ophthalmologists should be
aware of these newer treatments
because their patients might be using
these before surgery or concomitant-
ly with eye medications," Dr. Garg
said.
Familiarity with newer insulins
is important because introduction
of insulin to a patient with new or
uncontrolled diabetes can cause
worsening of retinopathy due to cer-
tain growth factors, Dr. Bandukwala
said. "Knowing the names of newer
insulins, such as Tresiba [Novo Nor-
disk, Bagsvaerd, Denmark], Basaglar
[Eli Lilly, Indianapolis], Fiasp [Novo
Nordisk], and Afrezza [MannKind
Corporation, Westlake Village,
California], can better inform the
eye doctor of this potential issue if it
arises," he said. EW
Miller:
joshua.miller@stonybrookmedicine.edu
Wang: drwang@wangvisioninstitute.com
Editors' note: The physicians have
no financial interests related to their
comments.
Contact information
Bandukwala: drbendocrinology@gmail.com
Garg: rgarg@med.miami.edu
Halprin: Elizabeth.Halprin@joslin.harvard.edu
