Keeping health professionals current with useful, quick updates on drugs & therapy - with CE for pharmacists, pharmacy technicians and advanced practice RNs.

Dry eye disease (DED) is a chronic, progressive, inflammatory disease of the ocular surface and lacrimal glands. The American Academy of Ophthalmology describes DED as inadequate moisture in the eyes due to changes in tear film consistency and the type of tears produced (leading to evaporative loss), with or without decreased tear production. The disease is also known as keratoconjunctivitis sicca, ocular surface disease, and dry eye syndrome. Nearly 12 million people in the US are coping with dry eye symptoms on a daily basis. The prevalence of DED among adults in the US is approximately 14%. The disease occurs twice as often in women, and increases in prevalence with age (3% at 35 years and nearly 19% at 75 years or older).

Many factors contribute to DED. It has been linked with various autoimmune diseases (eg, Sjogren’s syndrome, lupus, rheumatoid arthritis), diabetes, and thyroid disorders. DED has also been associated with blepharitis and rosacea. In addition, eyelids that are turned in (entropion) or out (ectropion) can result in DED. Postmenopausal women are at high risk for DED – most likely due to hormonal changes resulting in a reduced ophthalmic antiinflammatory response and decreased lacrimal secretions.

Dry eye disease takes its toll on patients economically and on their quality of life. Symptoms range from stinging, irritation, ocular fatigue, to variations in visual acuity. These can occur for extended periods of time and significantly impact a person’s daily activities. In a 2016 report on the humanistic and economic impact of DED in the US, the annual direct cost for managing the disease was estimated at $3.8 billion dollars....

This issue highlights the use of continuous glucose monitoring (CGM) systems, sodium glucose transport protein-2 (SGLT2) inhibitors, newer insulin formulations, and the expert guideline recommendations focused on individualization of therapy.

In 2017, the Centers for Disease Control reported that over 30 million people in the US (~10% of the population) have diabetes, including 7.2 million who are undiagnosed. The total estimated cost of diagnosed diabetes in the US was $327 billion in 2017.2 Individuals with diabetes incur average annual medical expenses of about $16,750 – more than twice the expense for people without diabetes.

Over the last decade, the options for managing diabetes have grown dramatically – including new medication classes (eg, glucagon- like peptide-1 agonists, sodium-glucose transport protein-2 inhibitors), new insulin analogs (eg, insulin degludec, biosimilar insulins), and new technologies to help patients monitor their diabetes (eg, continuous glucose monitoring).

Clinical practice guidelines have increased the emphasis on individualizing treatment options and goals to meet the needs of each patient. Patients have more say in the management of their diabetes and overall health. It is essential that healthcare providers help patients navigate the vast pool of information available at their fingertips. Diabetes patients can easily get confused by the often-conflicting information or misinformation available on television and the internet, and from friends and family members. Community providers need a good, working knowledge of patient-specific diabetes management, including current treatments and technologies...