Understanding the Disease
The part of the eye damaged in diabetic retinopathy
Retina
Diabetic retinopathy is the leading cause of this in working-age adults
Blindness
How do statins reduce cardiovascular risk?
By lowering LDL and stabilizing atherosclerotic plaques
Later stages of diabetic retinopathy cannot be reversed
TRUE
Name one role an NP can play in getting members screened for diabetic retinopathy
Educate on disease process and coordinate diabetic retinopathy exams
What is the primary lipid target of statin therapy
LDL
Early detection and treatment can reduce vision loss risk by up to this percentage
90%
What is the expected LDL reduction for high-intensity statin therapy
~50% from baseline
Muscle symptoms are always a reason to permanently stop statins
FALSE
A reply for a member stating "I don't have any eye problems so I don't need an exam"
Diabetic eye damage can happen silently,and screening finds problems early, even before you notice them
This is the primary pathogenic agent in diabetic retinopathy
Chronic hyperglycemia
Name one early sign of diabetic retinopathy
Blurred vision, floaters or may be asymptomatic
Controlling these can help prevent progression of diabetic retinopathy
Hyperglycemia, hypertension, dyslipidemia
A normal cholesterol level means a patient has no risk of heart disease
FALSE
Next best step if a member would like assistance now to schedule a diabetic retinopathy exam
Use the protocol and OKC cards to schedule the exam via three way call
This type of retinopathy is a more advanced stage which may include neovascularization
Proliferative diabetic retinopathy
10%
Name one high intensity statin and its dose
atorvastatin 40-80 mg or rosuvastatin 20-40mg
Statin use is associated with a slight increase in blood glucose
TRUE, but the cardiovascular benefit outweighs this small risk
Next best step if a member would like assistance at a later time ordering a diabetic retinopathy exam
Create a CA STARS Outreach
What enzyme do statins inhibit to lower cholesterol synthesis?
HMG-CoA reductase
What is the threshold for statin initiation in primary prevention?
ASCVD risk of 7.5%
Which statins have a lower side effect profile for muscle cramps?
Fluvastatin, pravastatin, and low dose rosuvastatin
Statins are effective for primary prevention even in patients with low baseline LDL
TRUE!
A plan if a member refuses the diabetic retinopathy exam
Educate, address barriers, document the refusal, plan a follow-up conversation