CDC Report Details Concerning Trends in Prevalence of Vision Impairment in Diabetes

Elizabeth Lundeen, PhD, MPH

A new study from the US Centers for Disease Control and Prevention (CDC) is raising a red flag on the incidence of vision impairment among patients with type 2 diabetes in the US.

An analysis of data from the US National Health Interview Survey, results of the study indicate that, after years of progress following the turn of the century, the declines in vision impairment prevalence among patients with diabetes had begun to plateau in 2012.

“While our findings of an increasing trend over the last decade did not reach statistical significance, it could be an early warning that trends in vision impairment among those with diabetes are headed in the wrong direction,” said Elizabeth Lundeen, PhD, MPH, senior scientist in the Vision Health Initiative at CDC. “Additional research will help us better understand the causes of this recent upward trend and design effective interventions to prevent vision loss in individuals with diabetes around the country.”

With diabetes a leading contributor to vision impairment and blindness among adults in the US, a greater understanding of trends can have. Substantial impact on quality of life for patients and the societal burden of the diabetes epidemic. Citing previous data suggesting a decline in glycemic control occurred in the US from 2007-2010 to 2015-2018, Lundeen and a team of colleagues from the CDC and the University of Michigan Kellogg Eye Center designed the current study to assess whether this may have impacted trends in vision impairment.

With this in mind, investigators designed their study as an analysis of self-reported data from 1999-2018 within the National Health Interview Survey. Launched in 1957, the National Health Interview Survey collects self-reported data in an attempt to characterize national trends in health. From the survey, investigators obtained data related to annual prevalence as single years and a 3-year moving average age-standardized to the 2010 US census.

The primary outcome of interest for the investigators’ analysis was the annual percentage change (APC) in the incidence of vision impairment. For the purpose of analysis, investigators assessed APC using Joinpoint regression with single years of data.

Upon analysis, using the 3-year moving average, investigators determined the prevalence of adults with diabetes who reported vision impairment decreased from 21.5% in 1999 to 20.7% in 2018, but this trend did not reach statistical significance (APC, -0.47; P=.2). Further analysis revealed the prevalence of vision impairment decreased significantly from 1999-2012, with an APC of -1.93 (P <.001), but this was followed by an inflection point in 2012. From 2012-2018, data from the analysis suggested the prevalence of vision impairment had begun to increase, but this trend did not reach statistical significance (APC, 2.86; P=.1). Of note, when examining the single-year prevalence, the greatest prevalence was observed for 2018, with 24.6% of patients with diabetes reporting vision impairment.

“These results suggest that declines in vision impairment among adults with diabetes mellitus seen in the first decade of the century may have plateaued in 2012. Future research could identify determinants, including glycemic management, vision screening, and healthcare utilization,” wrote investigators.

This study, “Twenty-Year Trends in Vision Impairment among U.S. Adults with Diabetes,” was presented at ADA 2022.