Novartis partners with local diabetes and eye specialists

FROM LEFT: Novartis Healthcare Philipines president and managing director Dr. Nikolaos Tripodis, PSEDM president Dr. Cecilia Jimeno and VRSP president Dr. Milagros Arroyo

Freelance writer and editor Malou Rosal has been suffering from diabetes for 20 years now and has been diagnosed with diabetes macular edema (DME) in the ’90s. A consequence of diabetic retinopathy, DME is characterized by changes in the blood vessels of the retina.

In patients with DME, leakage from these abnormal blood vessels occurs in the central portion of the retina called the macula. Because this part of the eye is responsible for sharp central vision, DME can lead to significant visual impairment.

Diabetes runs in Rosal’s family except for one who is not diabetic. Rosal is taking oral medication but she can be a pasaway (noncompliant) patient. She would visit her doctor irregularly. Once, when she ate a lot while on vacation, she experienced recurring (regular) headaches and her blood glucose (sugar) level rose to 300 mg/dL. (Blood sugar level is the amount of glucose in the blood. A normal sugar level is less then 100 mg/dL after fasting at least eight hours. It’s less than 140 mg/dL two hours after eating.) Because of this, she was rushed to the hospital and was confined there.

Rosal’s doctor was concerned about her health. She underwent eye operation, which was successful. Since then her attitude changed from refusal to comply with the advice of her doctors (ophthalmologist and endocrinologist) to willingness to do whatever they ask her to do. She’s now being invited to speak before diabetics with vision problems or before media practitioners who are concerned about public awareness on diabetes complications leading to blindness.

Rosal is among the 7.2 percent adults who have diabetes mellitus (DM) based on the national nutrition and health survey conducted in 2008.

Complications of DM

DM is a chronic or long-standing disease caused by persistently elevated blood sugar. It can cause a host of complications that can affect nearly every organ in the body if it is not controlled. The most well-known complications of DM are heart attack, stroke, kidney failure and leg amputation.

Among these complications is diabetic retinopathy (DR), which is one of the leading causes of blindness among adults.

The American Diabetes Association says that one in every four diabetic patients is prone to develop DR, also known as “diabetes of the retina.” Its most important risk factor is inadequate blood sugar control. DR involves changes in the structure of the retina, which is the light sensitive layer at the back of the eye. As it progresses, tiny new blood vessels develop. These can leak fluid and/or start to bleed, leading to blindness if untreated.

Blindness from DR can be prevented though. Patients must receive combined, cooperative and continued care from their ophthalmologists, their endocrinologists and their families.

Partnership

Not only to raise public awareness on DM and its complications, especially those affecting vision, but to prevent blindness as well, Novartis Healthcare Philippines recently forged a partnership with the Philippine Society of Endocrinology, Diabetes and Metabolism (PSEDM) and the Vitreo-Retina Society of the Philippines (VRSP).

To help address the “unseen threat” of DM, the three organizations signed a memorandum of agreement at Edsa Shangri-La Hotel in Mandaluyong City.

PSEDM president Dr. Cecilia A. Jimeno said: “This timely collaboration aims to increase public awareness on diabetes and its complications, particularly diabetic retinopathy and diabetic macular edema, both of which are leading causes of blindness among adults with diabetes mellitus. The partnership also aims to increase physician awareness, as local patients are often referred to eye specialists when their diabetic retinopathy is already in its advanced, irreversible stages.”

VRSP president Dr. Milagros Arroyo said, “Through this partnership, we will organize small group meetings or group discussions among local physicians that will focus on screening and diagnosis of diabetes mellitus complications, particularly diabetic retinopathy and DME.”

Referral system

VRSP vice president Dr. Sherman Valero said, “We will also establish a referral system between endocrinologists and eye specialists to enhance patient care and prevent blindness by catching diabetic eye complications early.”

Under the MOA, PSEDM will encourage its members to educate patients on the importance of early screening, diagnosis and referral to eye specialists for proper treatment of diabetic retinopathy and DME. It will also focus on the prevention of diabetic eye complications during the observance of Diabetes Awareness Week in July.

For its part, VRSP will encourage its members to educate their patients and patients referred to them about the importance of proper diabetic screening and regular follow-up with endocrinologists and ophthalmologists. It will also disseminate information on diabetic retinopathy during the observance of Diabetes Awareness Week on July 3.

Both groups will develop patient awareness materials for distribution during the Diabetes Awareness Week and Sight Saving Month in August.

“Novartis is privileged to partner with PSEDM and VRSP in enhancing diabetes care in the country,” said Dr. Nikolaos Tripodis, Novartis Healthcare Philippines president and managing director. “In response to our patients’ need to continue their medication with ranibizumab, Novartis is reducing the price of ranibizumab to enable more Filipino patients to benefit from its proven efficacy and safety,” he added.

Specifically designed for the eye and proven to save sight, ranibizumab is indicated for the treatment of neovascular wet age-related macular degeneration (wet AMD), visual impairment due to DME and due to macular edema secondary to both branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO); and visual impairment due to choroidal neovascularization (CNV) secondary to pathologic myopia (myopic CNV).

Modify risk factors

Jimeno said: “The way to prevent diabetes is to modify the risk factors for diabetes such as overweight and obesity or lack of physical activity—lifestyle modification with a healthy diet and regular exercise is key to preventing diabetes. We also advocate screening with those with risk factors such as family history, being overweight or obese, having high blood pressure or high cholesterol or for women, having diabetes during pregnancy. Even for asymptomatic adults who are 40 years old and above, routine screening with blood tests is recommended for early detection of diabetes.

“Likewise, to prevent diabetic eye diseases it is recommended that all diabetics be seen by an eye doctor or an ophthalmologist as soon as they are diagnosed, and on regular basis depending on findings. Again, through early screening and detection even without symptoms, diabetic retinopathy can be prevented and/or managed,” she added.