DIABETES and Diabetic Retinopathy
Diabetes occurs when glucose (blood sugar) levels are above the normal range (the upper limit is 120mg/dL). It is the 5th leading cause of death-70% of all these deaths occur from congestive heart failure. It is the LEADING cause of blindness worldwide.
KNOWLEDGE is key. Remember diabetes is a lifestyle condition.
- Understand your condition. Know what the numbers mean- If you are diabetic you are likely to have high blood pressure and high cholesterol- Get checked by your doctor. Don’t rely on pharmacy or home readings. Know your HBA1c, Glucose, Cholesterol, blood pressure readings. Keep a glucose log with time and meal recorded. Know your medication. Write it down.
- Take care of yourself. Don’t wait for your husband/wife/ children/ friends/ neighbours to check your numbers or to give you your medication. Make it your responsibility. Listen to your body- take time to acknowledge and understand your signs and symptoms.
- Check your feet and hands. Look for swelling in the ankles and change in skin colour. Areas with nerves that are damaged may not feel pain in the same way. Blisters and ulcers can develop if injuries are not cleaned and cared for.
- Encourage family members to be tested even if they are younger and under 40 years old. Retinopathy (bleeding in the eye) is often seen at time of diagnosis. It is thought that most people have the condition for 4-7 years before being officially diagnosed when there are no symptoms. We are busy and often don’t listen to our bodies. Make time to be checked by your GP.
- Exercise. Start by walking a few minutes a day
- Drink water
- Stop smoking.
- Remember it can be just as dangerous with glucose levels going too low. Always walk with a small snack and water if you are out.
- Lose weight if you are overweight. Belly fat is a strong indicator for the risk of stroke,
- Ask questions whenever you have a doctor/optometrist/ ophthalmologist/appointment. Take a family member with you. Write your questions down before so you don’t forget.
- Keep a positive attitude- Don’t say “I suffer with diabetes”- instead say “I live with diabetes. It’s all in your thinking.
Eat everything in moderation. The more refined, the higher the glycaemic index the worse it is for you. Talk to a dietician. Don’t deprive yourself completely – eat small meals several times a day. Eat whole grains, fruit, and vegetables.
Avoid heavy, fried, overcooked food. Avoid fast food, biscuits, cakes, ice cream. If it feels and looks heavy, it’s harder on the body.
Diabetes and THE EYE
- Once you are diabetic you should have an annual eye exam.
- To have a spectacle prescription checked, the blood glucose should be <200mg/dL. If it is higher than that, the prescription is affected. You may find vision varies from day to day, week to week.
- Cataracts can occur earlier in diabetics due to fluctuating glucose levels.
- Be careful about hygiene. Wash your hands. Don’t rub or touch the eyes as you increase the risk of infections. Diabetics lose nerve sensitivity and therefore healing is slower.
- Vitamins? I – Caps have lutein, zeaxanthin-these are anti oxidants. Will not cure damage already done but helps promote healthy tissues.
- The greatest danger of diabetes and the eye is bleeding of the retinal blood vessels. Blood vessel walls are damaged- blood and other fluids leak into the retina. The tiny blood vessel walls become damaged and start to leak blood and fluid. This gradually leads to vision loss. The patient may notice black spots and blurred vision in the early stages. The body tries to hep itself by growing new blood vessels but these are weak and fragile. This causes a pulling which can lead to bleeding in the vitreous and retinal detachment and very significant vision loss.
Treatment options for diabetic retinopathy.
- Laser: It’s not a cure. Simply seals leaking blood vessels.People are afraid to have it done, thinking it makes things worse. This is not true.Be afraid of the untreated bleeding.
- Vitrectomy: The vitreous gel is removed from the eye and replaced with saline solution when the small blood vessels in the retina start leaking.
Retinal Detachment: Silicone injected into the eye to keep the retina flat, or sometimes a scleral buckle.Treatment is expensive. Prevention and preservation is a better option
Once these procedures are carried out, vision is never realistically going to be as good as before. The key is keeping diabetes under control. Bleeding can occur again and again with poor control even after surgery and laser.