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Manage diabetes to prevent blindness

By Reema Patel, M.D., FACE

Diabetes is the leading cause of new cases of blindness among American adults between ages 20 and 74, with diabetic retinopathy as the most common diabetic eye disease. Changes in the blood vessels of the retina, the light sensitive layer at the back of the inner eye, can lead to this condition. In some people, retinal blood vessels may swell and leak fluid. In others, abnormal new blood vessels grow on the surface of the retina.  These changes may result in vision loss or blindness.

Patients with diabetes are at risk for diabetic retinopathy. The longer you have diabetes, the higher is your risk to develop diabetic retinopathy, particularly if your blood sugars are not at target. In the early stages, you may not have symptoms. Your vision may not change until the disease progresses. Later on, this may present as blurry or double vision, dark or floating spots, pain or pressure in one or both eyes, rings, flashing lights or blank spots. Hence, it is not only important to maintain good diabetes control, but also to see an ophthalmologist for early detection and treatment of diabetes related eye complications.

If you have diabetic retinopathy, your health care provider will determine the best treatment based on your age and medical history. The ophthalmologist may refer you to a retina specialist. Earlier detection and treatment increases the likelihood of preserving vision. Some treatments for diabetic retinopathy include laser surgery to shrink abnormal blood vessels in the eyes, a procedure called Vitrectomy replacing certain eye fluids with a saline solution, and chemotherapy to decrease the growth of abnormal blood vessels in the retina.

You should have a dilated eye exam at least once a year. Although that by itself does not prevent retinopathy, it can help diagnose eye problems earlier, which can then be subsequently treated. An eye exam can also alert you and your health care provider if your diabetes needs to be better controlled.

Diabetic eye disease is one of the several complications of uncontrolled diabetes besides others including increased risk for dental disease, kidney disease; nerve damage also called as neuropathy and increased risk of heart disease and stroke. These can develop in patients with diabetes, patients with higher HbA1c levels being at a higher risk. The best method to prevent the development of these complications is to follow your diabetes management plan carefully. This includes taking medicines and using insulin as directed, eating healthy to manage blood sugar levels as well as exercising to lower blood sugars. Regular testing of your blood sugar levels is also equally important.

Most important though is to keep appointments with your health care provider, even when you are feeling well. Diabetes unfortunately is a silent disease, which does not lead to any symptoms unless blood sugars are very high. Regular health care follow-up to evaluate diabetes control, and continued control of blood sugar slows the onset and progression of the complications and lessens the chance of the same.

Reema Patel, M.D., FACE, is medical director of the Joslin Diabetes Center, affiliate at Hackensack Meridian Health Raritan Bay Medical Center–Old Bridge. She is board certified in diabetes, endocrinology and metabolism, and internal medicine. The center provides the latest advances in diabetes treatment, patient education and support services, and is accredited with the ADA’s Education Recognition Certificate. Treatment of other endocrine disorders including, thyroid, parathyroid, osteoporosis, PCOS, low testosterone, adrenal and pituitary disorders is also provided. Dr. Patel is fluent in English, Hindi, Gujarati, Punjabi and Urdu. To make an appointment, call 732-360-4070. 

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