Diabetic Macular Edema: The Value of Slowing Progression

Kenneth J. Snow, MD, MBA: We put a significant value on preventing disease progression. We know that diabetes is a chronic illness and the complications come about over the course of time, and we would like to keep our members as long as possible. Therefore, it’s to our advantage to provide them the services they need. At the end of the day, it’s also the right thing to do. Even if they will be moving to a different company or a different type of coverage, it’s still the right thing to do—to make sure that people have the care they need. In today’s world, in the field of diabetes and particularly in diabetic eye disease, we have a very good sense of what the right thing to do is.

For our members with diabetic eye disease, we have our diabetes management program, and we outreach to members to make sure that they’re getting appropriate therapies and that they’re getting the medications they need. We can check to see if their coverage for the medication comes through us, and we know if they’re filling their prescriptions. We know if they’re getting their medications. If they’re not, we can investigate why that may be. We can contact their physicians.

We also know that beyond just the issue of diabetes and blood sugar control, that there are other risk factors that also significantly impact diabetic eye disease. High blood pressure is a common problem for folks with diabetes. So, our disease management folks will reach out to our patients, not just for their diabetes, but also to deal with the issue of their blood pressure. Are they seeing the physician? Has it (blood pressure) been checked? Is it well controlled? Are they able to get their medications?

Another risk factor for diabetic eye disease is smoking. We know that there’s a lot of good reasons to quit smoking, but one that is often not recognized is that smoking does increase the likelihood of having diabetic eye disease and progressing. We have case managers who will reach out to our members who have diabetes and who also smoke to encourage them to quit smoking and to see what kind of a program we can get them into to help them with that. [We want to] make sure that they understand what their options are and what their benefits are [in order] to help them to quit smoking, which, of course, is good for their health, but also has the benefit of being good for their eyes.