The Future Outlook on Diabetes Care and the Prevention and Treatment of Eye Diseases

Peter Salgo, MD: We’ve reviewed a lot of information in diabetic macular edema. We’ve explored ways to improve the management of the disease at the provider and at the health plan levels, too. And before we end this peer exchange, what I’d like to do is get some final thoughts from each of our panelists. Dr. Kitchens?

John W. Kitchens, MD: We’re in a really exciting time for what we do as retina specialists. We have treatments now that are able to restore vision in many patients. Early treatment is critical to preventing retinopathy progression and reversing retinopathy. It’s a magical time to be a retina specialist.

Probably, the most moving thing that I do is when you can actually turn to that patient and say, “You know what, you’re going to get better.” They never hear that. And it’s a message of hope that we can give our patients—that if they follow up and if they receive proper treatment, they’re going to see improvement in their vision, improvement in their eye. It rejuvenates them. I’ve had more than one patient who has gone from an A1c of 13 to 7, stopped smoking, and lose weight because they not only understood how this was affecting their eyes and their body, but finally felt like they were enabled to take charge of their disease.

Peter Salgo, MD: Dr. Peskin?

Steven Peskin, MD, MBA, FACP: So, we really dealt with the micro and the macro. We lasered into this important clinical complication of diabetes. We talked about some of the challenges and issues associated with getting the screening done and then getting the right treatment for the right patient at the right time. And, certainly, within this area, we recognize the importance of that.

That said, there is this macro environment we’re dealing with where there are a whole variety of competing interests. I am saying I am enthusiastic because I do believe that as we work collaboratively, collegially, as you said Peter, with our clinical partners, that we’re going to see improvements in overall care, attenuating or bending the cost curve as they say inside the Beltway, and seeing better levels of patient experience of care.

Peter Salgo, MD: Dr. Singh? Last but not least.

Rishi P. Singh, MD: The points that John made are really quite important, I think. The outcomes of our patients now can be assuredly good with proper intervention, proper screening, and proper care. And there’s really no reason why any patient who’s diabetic now should go blind, given our current therapies and given our current options.

We have had a revolution in care to the point where you’d consider what we have right now the statins of cardiology. And, in that sense, we’ve really come a long way in our field where we had nothing and we have something that’s really quite tangible and quite good for the patient, and outcomes in respect of that.

Peter Salgo, MD: It’s remarkable. Sitting here, one of the great joys I have is listening to these panels from time to time. This has been, again, pun intended, an eye opener.

It’s amazing. I have heard for the first time in my career that we can take diabetic retinopathy and turn it around. That’s nothing short of miraculous and I am privileged to practice in this environment and privileged to be at this table with all of you.

That being said, we are just about done. So, on behalf of our panel and the editors at the American Journal of Managed Care, I want to thank you for joining us. We hope you join us again. I’m Dr Peter Salgo and I’ll see you next time.

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