title: Ocular disease, knowledge and technology applications in patients with diabetes.
abstract: An estimated 25.8 million children and adults in the United States, approximately 8.3% of the population, have diabetes. Diabetes prevalence varies by race and ethnicity. African Americans have the highest prevalence (12.6%), followed closely by Hispanics (11.8%), Asian Americans (8.4%) and whites (7.1%). The purpose of this article was to discuss the ocular complications of diabetes, the cultural and racial differences in diabetes knowledge and the role of telemedicine as a means to reach the undeserved who are at risk of complications. Information on the pathophysiology of ocular disease in patients with diabetes and the role of telemedicine in diabetes care was derived from a literature review. National Institutes of Health online resources were queried to present data on the racial and cultural understandings of diabetes and diabetes-related complications. The microvascular ocular complications of diabetes are discussed for retinopathy, cataracts, glaucoma and ocular surface disease. Racial and cultural differences in knowledge of recommended self-care practices are presented. These differences, in part, may explain health disparities and the increased risk of diabetes and its complications in rural minority communities. Finally, advances in telemedicine technology are discussed that show improvements in metabolic control and cardiovascular risk in adults with type 2 diabetes. Improving provider and patient understanding of diabetes complications may improve management and self-care practices that are important for diabetes control. Telemedicine may improve access to diabetes specialists and may improve self-management education and diabetes control particularly in rural and underserved communities.
authors.affiliation: East Carolina University, Greenville, North Carolina.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Threatt
authors.affiliation: The University of North Carolina at Chapel Hill (JFW, KH, RMD), Chapel Hill, North Carolina.
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Williamson
authors.affiliation: The University of North Carolina at Chapel Hill (JFW, KH, RMD), Chapel Hill, North Carolina.
authors.forename: Kyle
authors.initials: K
authors.lastname: Huynh
authors.affiliation: The University of North Carolina at Chapel Hill (JFW, KH, RMD), Chapel Hill, North Carolina. Electronic address: richdavis@unc.edu.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Davis
authors.affiliation: School of Medicine and Health Sciences, George Washington University, Washington DC.
authors.forename: Kathie
authors.initials: K
authors.lastname: Hermayer
mesh_terms: D003930:Diabetic Retinopathy / Q000209:etiology* / Q000473:pathology; D005123:Eye / Q000473:pathology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017216:Telemedicine / Q000639:trends