As someone living with diabetes, managing your blood sugar is the only way to avoid serious diabetes-related health complications, including heart disease, kidney disease, and nerve damage. What you might not know is that diabetes is also the primary cause of blindness in adults ages 20 to 74. The major culprit is a condition known as diabetic retinopathy.
Diabetic retinopathy is the direct result of high blood sugar due to diabetes. Over time, having too much sugar in the blood can damage blood vessels all over the body. In diabetic retinopathy, this happens in the part of your eye that detects light and sends signals to your brain through the optic nerve - the retina.
What is Diabetic Retinopathy?
Diabetic retinopathy is an eye condition in which the blood vessels of the retina begin to swell and leak. They can even close entirely and stop blood from passing through to the eye altogether. If left unchecked, diabetic retinopathy can cause new blood vessels to begin forming in the retina, furthering the damage, and possibly leading to a loss of vision.
There are two stages to diabetic retinopathy:
Nonproliferative diabetic retinopathy (NPDR)
This is the early stage of the disease. As NPDR progresses, the walls of the blood vessels in the light-sensitive tissue of back of the eye begin to weaken. Eventually, they swell and leak fluid and blood into the retina. This can cause the retina to swell, a condition known as macular edema, which can initially result in mild vision impairment but can lead to permanent vision loss if not properly treated.
Proliferative diabetic retinopathy (PDR)
PDR is the more advanced stage of diabetic retinopathy. In this stage, abnormal and fragile new blood vessels begin to grow on the surface of the retina. These vessels may burst and bleed into the vitreous (the clear and watery gel that fills the eye). Depending on the severity of the leakage, this can result in a host of serious vision problems, from dark floaters in the field of vision to peripheral vision damage to total vision loss. Additionally, the new blood vessels grown during the PDR phase of diabetic retinopathy can create scar tissue which in some cases can cause the retina to detach.
Symptoms of Diabetic Retinopathy
The symptoms of diabetic retinopathy mirror the symptoms of diabetes in the sense that in the early stages of the disease you’re likely to feel zero signs anything is wrong. If there are any early symptoms, they are somewhat vague, such as having trouble reading or viewing far away objects, which most people chalk up to as age-related. The bottom line is most people have no idea they’re in the early stages of diabetic retinopathy. However, as the disease progresses, symptoms will begin to reveal themselves. The signs may include:
– Blurred vision
– Vision that fluctuates from blurry to clear
– Seeing dark floaters in your field of vision
– Degrading night vision
– Seeing blank or dark areas in your field of vision
– Noticing that colors appear faded or washed out
– Losing vision peripherally or entirely
Risk factors of Diabetic Retinopathy
Anyone who is living with diabetes is at risk for diabetic retinopathy. The longer you have diabetes, the greater the likelihood you will develop retinopathy. So, whether you have Type 1 or Type 2 diabetes, regular eye doctor visits should be part of your diabetes treatment plan.
Additionally, women with diabetes who become pregnant or who develop gestational diabetes during their pregnancy are at a high risk for diabetic retinopathy. If you have diabetes and are pregnant, be sure to include a thorough eye exam as part of your health program.
How can I prevent Diabetic Retinopathy?
There’s no way to entirely negate your risk of diabetic retinopathy. If you have diabetes, you face some level of risk. However, the best thing you can do to minimize the likelihood of developing the disease is to make sure your blood sugar stays within your safe target range.
Following your doctor-prescribed blood sugar testing and treatment program is the key to lowering your risk of diabetic retinopathy. Test your blood sugar regularly using a glucose meter and the appropriate test strips. If your doctor recommends a continuous glucose monitoring system (CGM), make sure you follow instructions accordingly and have an ample supply of any necessary sensors and transmitters.
Also, make it a point to stick to your doctor-prescribed medication plan, whether it includes insulin injections by syringe or pen needle, or any other medications. Then, of course, there are those healthy lifestyle choices all of us living with diabetes must make - eat right, exercise, lose weight if necessary, avoid excessive alcohol consumption, you know the routine.
The risk of diabetic retinopathy is also increased if you have high blood pressure, a common occurrence in people with diabetes. If you have it, work with your doctor and care team to get it under control. Finally, pay attention to vision changes. If your vision suddenly becomes spotty or blurry, see your eye doctor as soon as possible.
Diagnosing Diabetic Retinopathy
It’s important to make sure you get a diabetic eye exam at least once a year. This is the easiest way to spot the beginnings of diabetic retinopathy or any other diabetes-related eye issues before they develop into more serious conditions.
Your eye doctor may perform any of the following tests to diagnose diabetic retinopathy:
Visual Acuity - The standard eye chart most of us have experienced at one point or another which measures central vision at varying distances.
Tonometry – This test measures the pressure inside the eye.
Pupil Dilation - Drops are place in the eye which widen the pupil allowing the physician to get a detailed look at the eye lens and retina.
Ophthalmoscopy – This special magnifying device allows doctors to examine the retina in more detail.
Fluorescein Angiography – Organic dye is injected into the bloodstream to reveal the vessels in the eye. Images are then taken that can show doctors if the blood vessels are leaking or if blood flow to the retina is impeded.
Optical Coherence Tomography – This technology uses light waves to provide detailed images of the retina.
How is Diabetic Retinopathy treated?
This depends on your age and whether you’re in the initial stages (NPDR) or the later stages (PDR) of diabetic retinopathy. The good news is that people with diabetic retinopathy have a very good chance of keeping their vision as long as the condition is treated before the retina becomes too severely damaged. Treatment might include:
– Laser surgery to shrink abnormal blood vessels or seal leaking ones.
– Vitrectomy, a process by which the vitreous is removed and replaced with a saline solution.
– Injection of certain medications to slow the growth of abnormal vessels and treat macular edema.
Living with diabetes means taking added precautions in many aspects of our lives. Vision is certainly one of them. Diabetic retinopathy is a serious condition, but if you’re maintaining proper control over your blood sugar and diabetes health, then you can feel confident you’re doing everything you can to prevent or delay the onset of the disease.
We hope you found this post informative and helpful. At Diabetic Warehouse, we’re committed to keeping you up to date with the latest news and tips on living with diabetes. We’re also committed to saving you up to 65% on doctor-recommended diabetic supplies from leading manufacturers, such as Accu-Chek, OneTouch, FreeStyle, Easy Comfort, Clever Choice, TRUEmetrix and many others.
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