Diabetes and Diabetic Nursing Care

Diabetes mellitus is an epidemic worldwide. Primary care providers, including advanced practice registered nurses, can play a vital role in both the treatment of the disease and prevention of complications, particularly diabetic macular edema. A working understanding of the disease process and early referral is of exceptional importance as well as long term treatment options their patients may receive from their Ophthalmologist. ILUVIEN® (fl uocinolone acetonide intravitreal implant) 0.19mg is an implant injected into the eye (vitreous) and used for the treatment of diabetic macular edema in patients who have been treated with corticosteroids before and did not have a significant increase in eye pressure. The implant can work for up to 36 months. To understand how the drug can improve vision and decrease edema, one must understand the pharmacokinetics of the drug as well as its lipophilic nature. Lipophilicity is the reason so little of the drug is required to achieve these results. Not all corticosteroids have the same lipophilicity, water solubility and tissue penetration. It is important for the primary care provider to appreciate the features of the drug and understand the implications of diabetic macular edema. Assertive, collaborative treatment imperative for this patient population to maintain vision through their life time.