Diabetic retinopathy (ret-tin-OP-a-thee) is a complication of diabetes mellitus. In diabetes mellitus, the body is unable to either produce enough insulin or, in some cases, to use the insulin it produces. That causes sugar (glucose) to stay in the blood instead of entering the cells of the body, where it is needed. Most often, the disorder can be controlled through diet and medication, which normalize the blood-sugar level and the way the cells utilize the sugar. For reasons that are not completely understood, diabetes, even when controlled, also affects the blood vessels, especially in the kidneys and eyes.
There are two types of diabetes mellitus: type I, formerly called juvenile diabetes because it strikes mainly children and young adults; and type II, formerly called adult-onset diabetes because it strikes mainly adults. In type I diabetes, the body’s immune system destroys the insulin-producing beta cells in the pancreas. Therefore, type I diabetics must give themselves insulin--either by injection or pump--on a daily basis to keep their blood sugar from rising to dangerous levels, which can cause coma and death. The classic symptoms of type I diabetes are frequent urination, excessive thirst and hunger, and weight loss. The disorder affects about 700,000 Americans, but predictions are now that by 2050, 1 in 3 Americans will have diabetes.
Type II diabetes mellitus has nothing to do with the immune system. It is caused by a combination of insulin resistance and improper secretion of insulin. In the beginning, it usually can be controlled with diet, exercise, and oral medications. Eventually, however, 40 percent of type II diabetics require insulin injections. The symptoms--including blurred vision; frequent or recurring infections of the skin, gums, or bladder; and tingling and numbness in the hands or feet--appear more gradually than do the symptoms of type I diabetes, so many people with type II diabetes only become aware that they have the disorder when they develop one of its life-threatening complications.
Early in the onset of diabetes, before the blood sugar is brought under control, diabetics often experience blurred vision. This is because the high blood sugar causes changes in the lens within the eye. Blurred vision may, in fact, be the first sign of diabetes. After the proper insulin dosage is determined and the disease is stabilized, the blurred vision from the lens change resolves, although it may recur if the blood sugar rises again.
Diabetic retinopathy(repetition from first paragraph)occurs about ten to twelve years into the disorder, but can occur earlier. It involves dilation of and small hemorrhages in the blood vessels of the retina. These can occur without any symptoms, unless the macula is affected. If the macula is affected, you may see spots or streaks in your vision that correspond to the blood-vessel leaks in the retina. If left unchecked, these hemorrhages and fluid leaks will eventually spill into the vitreous of the eye. Once in the vitreous, they can scar and pull on the retina, often causing retinal detachment and blindness. Diabetes is the second leading cause of adult blindness. It is important to note, however, that not all diabetics develop diabetic retinopathy.
If you have diabetes, you should be checked yearly by an optometrist experienced with the disorder. Your optometrist should be qualified to follow the progression of the disease and be able to counsel you on appropriate care. However, when it comes time for treatment of diabetic retinopathy, you will need to see an ophthalmologist, who will have to perform surgery. The hemorrhages of diabetic retinopathy can be stopped with a laser in a painless outpatient procedure that takes about half of an hour.
Exactly what does the medical laser do? It is directed at the retina, where it “spot welds” the hemorrhages. The laser administers hundreds to thousands of flashes of light to the affected eye. Anesthesia is unnecessary, although your eyes will be dilated and you may feel somewhat “dazzled” afterwards.
The best treatment for diabetes and, therefore, diabetes retinopathy is to prevent them from beginning in the first place. Watching your diet is the number one controllable factor to prevent type II diabetes. In fact, over 75 percent of all overweight people have their weight problem due to excess insulin in the body. The next concern is low blood sugar, or hypoglycemia. Excess insulin production and over-active insulin receptor sites cause low blood sugar. The Institute of Nutritional Science has specialized in Syndrome X (a catchall term for a group of problems that share a common cardinal cause, namely excess insulin in the bloodstream)and the related problems of obesity, hypoglycemia, low blood sugar and diabetes, and offers a three-phase program for both managing and preventing this devastating cycle of disease. Natural alternatives to controlling blood sugar have come a long way in recent years. Chromium, vanadium, alpha lipoic acid and select herbal extracts in key combinations, have shown to lower insulin and blood sugar levels both safely and effectively. Chromium naturally helps to lower blood sugar by sparing glucose usage. Vanadium has a direct effect on the insulin receptor sites of the body, making them much more effective. The end result is lowered insulin requirements. The key in managing conditions such as hypoglycemia and type II diabetes is lowering insulin levels. Chromium, vanadium alpha lipoic acid and key herbal extracts have proved very effective in lowering both insulin and blood sugar levels naturally. If you are significantly overweight and lower calorie diets have not worked well for you in the past, consider taking our Weight Management Test to help discover if your weight problem could be due to excess insulin production in response to carbohydrate ingestion.There is also a hereditary factor, so if you have a parent with diabetes, you are automatically at high risk and should be especially careful to eat a healthy diet and get regular medical check-ups.
However, if you are already affected with diabetes, there is evidence that staying in good diabetic control--that is, keeping the blood-sugar level normal through diet and insulin--minimizes the long-term, as well as short-term, complications of the disorder.
Have your blood-sugar level checked regularly, especially if diabetes runs in your family.
If you notice any fluctuations in your vision, either day-to-day or within the day, request that you be tested for diabetes.
Since diabetes is a systemic disease, even the control of diabetic eye changes is initially done using general treatments such as diet and exercise.
Once you are diagnosed with diabetic retinopathy, you should have a dilated eye exam once a year, and more often if recommended by your doctor.