SECO 2023: Diabetes then and now

Paul Chous, MA, OD, FAAO, sat down with Optometry Times® assistant managing editor, Emily Kaiser, to chat about his discussion titled, "Diabetes: Then and Now," which he presented during the 2023 SECO meeting, in Atlanta, Georgia.

Editor's note: This transcript has been edited for clarity.

Kaiser:

Hi, everyone. I'm Emily Kaiser with Optometry Times. And I'm sitting down with Dr. Paul Chous, who presented, "Diabetes: Then and Now," at SECO 2023 in Atlanta, Georgia. Welcome, Dr. Chous!

Chous:

I'm so thrilled for me to have the chance to do this. The talk I gave on "Diabetes: Then and Now" was part of a 3-part series that Paul Ajamian kind of at SECO put together that one, "Glaucoma: Then and Now" and, and one about "Comanagement: Then and Now." So I kind of rounded out the fair with "Diabetes: Then and Now."

Kaiser:

How should clinicians respond to this information?

Chous:

Well, I think the key thing is to be grateful that we have all these wonderful new diagnostic technologies, but also therapies that can really prevent vision loss. The, you know, you hear this statistic bandied about and nobody's really proven it. I don't know how you go about proving it. But the thought is that about 90%+ of all severe vision loss from diabetes could be prevented with early control, regular followup of patients--surveillance, that is--and then treatment when it's indicated. So I think that's kind of the key message.

And one of the key messages I tried to drive home is that we now know, based on something called metabolic memory where bad glucose control, even even though you get it under control subsequently down the road, patients are still way more likely to lose vision. And so if we can get early, tight blood glucose control, that dramatically lowers the risk of needing these vision-saving interventions like laser and injections into the eye.

Kaiser:

Yeah, absolutely. And what do you hope optometrists take away from your talk?

Chous:

Well, primarily, that diabetes is everywhere. So there's so many people with diabetes, the estimate is that every other adult patient we see either has diabetes, or has pre-diabetes, which is a high risk factor for developing Type 2 diabetes.

Be aware about things we can do to tell patients, you know, lifestyle changes, so they can prevent diabetes, and once they get it, how to prevent vision loss from the disease.

Kaiser:

Is there anything else you'd like to cover that we haven't touched on?

Chous:

I think it's simply—I showed this picture of myself standing with The Rookies; you're too young to remember this. But it was a police drama show on in the 1970s. And I relayed the story about this one famous actor named Sam Melville, he unfortunately passed away in his 50s. But I was a 9-year-old kid, and he brought me into his trailer. And he was the nicest man in the world to me. I was there with Kate Jackson, one of Charlie's Angels. And they both actually said to me, you know, we've been reading about diabetes--I gave them an award for doing a television episode about diabetes--and they both said, you know, we're gonna have a cure for this disease and another 5 years. And that's something a lot of us with diabetes have been hearing every 5 years. We hear it's only another 5 years.

So I think optometrists should be aware is that the reality is we're closer to treatments and actual prevention of diabetes, far closer than we've been at any point in the past. And so I think optometrists play a fundamentally important role in helping patients avoid diabetes, diagnosing it before maybe their family physician diagnoses it, and then, of course, participating meaningfully in the diabetes care team.

Kaiser:

Thank you so much for taking the time to chat today. This has been illuminating.

Chous:

My pleasure. Thanks so much for having me.