Protecting Eye Health With Type 2 Diabetes
Diabetes affects nearly eight percent of the U.S. population—that's 24 million people. Treating diabetes costs over $174 billion per year. Up to 95 percent of those have type 2 diabetes and are at risk for eye diseases such as diabetic retinopathy. Type 2 diabetes occurs when your body’s cells cannot use insulin effectively, even though your pancreas produces enough of it. This is called insulin resistance and the symptoms build gradually or aren’t present at all, making type 2 an insidious disease.
Type 2 symptoms include:
- Fatigue, which can be extreme
- Frequent urination and increased thirst
- Unusually hungry all the time
- Weight loss or inability to lose weight
- Vision problems, such as blurred vision
- Slow wound healing
Untreated or badly treated diabetes commonly leads to eye complications. There are tiny blood vessels in your retina, located in the back of your eyes. An eye doctor dilates your eyes in order to see changes in your retinas and to check your eyes for sugar. Unfortunately studies estimate that only 40 to 65 percent of diabetics get annual eye exams. Your eyes can be irreparably damaged by high blood glucose, also known as high blood sugar. Diabetic retinopathy and macular edema are the two main conditions resulting from diabetes that ultimately may lead to blindness.
Diabetes and Eye Health: Diabetic Retinopathy
People who badly manage their diabetes or who go for years without knowing that they have diabetes have blood glucose levels that spike and plunge eventually causing vascular damage to their eyes. This damage is called diabetic retinopathy. The fifth leading cause of legal blindness in the United States, diabetic retinopathy affects more than 2.5 million worldwide between the ages of 20 and 65. It’s estimated that three-quarters of those with diabetes for at least a decade will develop some form of diabetic retinopathy.
There are two stages: non-proliferative and proliferative.
- Non-proliferative—stage 1 or pre-proliferative retinopathy: Enlarged capillaries within your retina may suffer aneurysms creating small blisters and hemorrhages on the retinal surface. This causes your retina’s surface to become uneven which can make your vision blur. Eyes may also leak water, proteins and fats into your retinal tissue. There are usually little or no symptoms at this point, which is why you should get your eyes dilated at least annually.
- Proliferative—stage 2: Because the original blood vessels or capillaries were damaged in stage 1, neovascularization occurs. Neovascularization means that the original blood vessels lacked oxygen causing new blood vessels to form. These new, but weaker, vessels are prone to breaking and bleeding into the vitreous fluid in the back of your eye. When this happens, it can block your vision. If scar tissue develops, your retina can detach, causing blindness. Type 1 diabetes is more likely to incur proliferative diabetic retinopathy.
Macular edema occurs when the macula in your retina swells. This happens usually in the non-proliferative stage of diabetic retinopathy. That swelling causes blurred vision. This may be the only symptom that you have during stage 1. Vision loss can be sudden and permanent. Treatment for macular edema with laser therapy doesn’t improve damage but can prevent worsening damage. If untreated, one-quarter of those with macular edema suffer moderate vision loss within three years. It’s estimated that around 14 percent of diabetics have this condition and that if you use insulin for over 20 years, your rate increases to nearly a third.
Diabetes and Eye Health: Cataracts and Glaucoma
Diabetics have a higher incidence of cataracts and glaucoma. Cataracts occur when the clear lens of your eye becomes cloudy, impairing vision sometimes to the point of blindness. Glaucoma occurs when pressure builds in your eyes, causing irreparable damage to the optic nerve, a leading cause of blindness. As diabetes increases worldwide, so do cataracts and glaucoma. Those with type 2 diabetes and uncontrolled high blood sugar develop cataracts when the blood glucose clouds the normally clear lens, sometimes to high opacity. Sugar and water are absorbed into the lens through osmosis, a biological movement where, in the case of diabetics, the sugar and water mix, entering the permeable lens, leaving an area of higher concentration for an area of lower concentration, leaving the lens cloudy, creating vision loss. Glaucoma is progressive and irreversible once the optic nerve is damaged beyond repair. Diabetics must take steps to protect their vision by visiting their eye doctors annually for a diabetic eye exam.
Diabetes and Eye Health: Protect Your Vision
It is expected that 439 million people will suffer from diabetes worldwide by 2030, according to the International Diabetes Federation. The key to preventing eye damage from diabetes is to manage your chronic disease and monitor it closely. This means annual eye checkups and dilations, getting your A1C checked and monitoring your blood glucose levels and diet. Your doctor should be a specialist in eyes - an ophthalmologist. You need someone specialized in the eye care of diabetics to significantly impact early detection and circumventing diabetic retinopathy and its complications.
