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OPTOMETRIC CLINICAL PRACTICE GUIDELINE

OPTOMETRY: THE PRIMARY EYE CARE PROFESSION
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. Optometrists providemore than two-thirds of the primary eye care services in the United States. They are more widely distributed geographically than other eye care providers and are readily accessible for the delivery of eye and vision care services. Approximately 37,000 full-time-equivalent doctors of optometry practice in more than 7,000 communities across the United States, serving as the sole primary eye careproviders in more than 4,300 communities. The mission of the profession of optometry is to fulfill the vision and eye care needs of the public through clinical care, research, and education, all of which enhance the quality of life.

Care of the Patient with

Diabetes Mellitus

OPTOMETRIC CLINICAL PRACTICE GUIDELINE
CARE OF THE PATIENT WITH DIABETES MELLITUS Reference Guide for CliniciansThe 1st edition was prepared by (and 2nd and 3rd editions reviewed by) the American Optometric Association Consensus Panel on Diabetes: Larry Alexander, O.D., Chair; Allen Blume, O.D.; Jerry Cavallerano, O.D., Ph.D.; Brian Den Beste, O.D.; Jerry Pederson, O.D.; Lesley L. Walls, O.D., M.D. (1st,2nd) in conjunction with the Center for Vision Care Policy of the State College of Optometry, StateUniversity of New York: Barry Barresi, O.D., Ph.D.; Mort Soroka, M.P.A., Ph.D.; Gary Oliver, O.D.; Claudia A. Perry, M.L.S.; Leonard Werner, O.D. Edited and revised by: Jerry Cavallerano, O.D., Ph.D. (1st, 2nd, 3rd); Ramachandiran Cooppan, M.D. (1st, 2nd, 3rd); Sven-Eric Bursell, Ph.D. (1st) Reviewed by the AOA Clinical Guidelines Coordinating Committee: John C. Townsend, O.D., Chair (3rd); John F.Amos, O.D., M.S. (1st, 2nd, 3rd); Kerry L. Beebe, O.D. (1st); Jerry Cavallerano, O.D., Ph.D. (1st); John W. Lahr, O.D. (1st); Thomas L. Lewis, O.D., Ph.D. (2nd); W. Howard McAlister, O.D., M.P.H. (3rd); Stephen C. Miller, O.D. (2nd, 3rd) Michael W. Rouse, O.D. (2nd); Richard L. Wallingford, O.D. (1st) Approved by the AOA Board of Trustees June 23, 1993 (1st), September 10, 1998 (2nd), and August 17,2002 (3rd) ©American Optometric Association 1993, 1998, 2002 243 N. Lindbergh Blvd., St. Louis, MO 63141-7881 Printed in U.S.A.

Edited and revised by: Jerry Cavallerano, O.D., Ph.D. (1st, 2nd, and 3rd Editions)

Reviewed by the AOA Clinical Guidelines Coordinating Committee: David A. Heath, O.D., Chair John F. Amos, O.D., M.S. Stephen C. Miller, O.D.

Approved by the AOA Board ofTrustees: June 22, 2009

©American Optometric Association 2009
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NOTE: Clinicians should not rely on the Clinical Guideline alone for patient care and management. Refer to the listed references and other sources for a more detailed analysis and discussion of research and patient care information. The information in the Guideline is current as of the date of publication. It will be reviewedperiodically

Diabetes Mellitus iii
TABLE OF CONTENTS INTRODUCTION ............................................................................................ 1 I. STATEMENT OF THE PROBLEM ................................................. 2 A. Description and Classification of Diabetes Mellitus .................... 3 1. Diabetes Mellitus................................................................ 3 a. Type 1 Diabetes Mellitus .......................................... 4 b. Type 2 Diabetes Mellitus .......................................... 5 c. Impaired Glucose Tolerance ..................................... 6 d. Gestational Diabetes Mellitus ................................... 6 e. Other Specific Types of Diabetes ............................. 7 2. Treatment of Diabetes Mellitus...