New recommendations to protect the sight of women with pre-existing diabetes during pregnancy are being developed by researchers from Australia and Indonesia.
During pregnancy, women with Type 1 and Type 2 diabetes are at particular risk of diabetic retinopathy, which can lead to severe vision loss or blindness if left untreated.
Often people with diabetic retinopathy do not notice any problems until it is too late, which is why routine eye checks are critical to prevent vision loss.
Centre for Eye Research Australia (CERA) researchers Dr Felicia Widyaputri and Associate Professor Lyndell Lim are working with colleagues from the Universitas Gadjah Mada, Indonesia, to develop advice on when and how often women with diabetes should have their eyes checked during pregnancy.
Their research, funded by the Alfred Felton Bequest in Australia and the Australian Indonesia Institute in Indonesia, will inform a major public health initiative for pregnant women with diabetes in both countries.
Diabetes is a major public health issue in Indonesia. It ranks No. 6 in the world for the prevalance of Type 2 diabetes and the number of Indonesians with diabetes will rise from 10 to 21 million over the next decade.
The Indonesian study will determine the prevalence of diabetes in Jogjakarta's pregnant women and their access to eye care.
It will then utilise findings from Dr Widyaputri's current PhD research at CERA, which is monitoring the eye health of 150 women with pre-existing diabetes before and during pregnancy.
Dr Widyaputri's study, which aims to determine the prevalence of diabetic retinopathy in pregnancy and its progression, follows the women throughout pregnancy, examining their eyes each trimester and when their baby is three months old.
Working with women at Melbourne's Royal Women's and Mercy hospitals, Dr Widyaputri is also monitoring their eyes for the earliest signs of diabetic retinopathy changes using a non-invasive imaging technique that can visualise the blood vessels in the retina.
Dr Widyaputri's research will be used to inform Indonesian health protocols for the care of pregnant women with diabetes, and will also provide valuable information which could contribute to an update of current Australian guidelines.
"Although it is largely agreed that diabetic retinopathy is worsened by pregnancy, there is still more we can do to protect women's sight,'' says Dr Widyaputri.
"Current Australian guidelines recommend that pregnant women with diabetes undertake a comprehensive eye check in their first trimester, but less than 50 per cent have their eyes checked.
"With our study we hope to get a clearer perspective of how far diabetic retinopathy can progress during pregnancy and when are the best points of time for patients to have their eyes checked.
"We know that a patient with diabetic retinopathy will not have symptoms in the early stages and by the time they are experiencing changes it can be too late to treat – that's why screening is so critical.
"I have seen how hard pregnancy is for women who have diabetes, as they have a number of appointments on top of the everyday responsibility of blood glucose monitoring.
"Getting a routine diabetic eye screen is very important during pregnancy. Because nothing is better than seeing your baby grow.''
