Almost 70 per cent of people diagnosed with high blood sugar levels have some stage of Diabetic retinopathy and about 25 per cent life-time risk of developing foot ulcers. Doctors suggests ways to deal with these complications
Diabetic eye disease refers to a group of eye problems that people with Diabetes may face as a complication of Diabetes. All can cause severe vision loss or even blindness.
Diabetic eye disease may include:
Diabetic retinopathy: Damage/leakage of the blood vessels in the retina as a result of increased blood glucose.
Cataract: Clouding of the eye’s lens. Cataracts develop at an earlier age in people with diabetes.
Glaucoma: Increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults.
Of the three, Diabetic retinopathy is the most common, least symptomatic is early stages and most destructive cause of vision loss. It is caused by changes in the blood vessels of the retina such as swelling and leakage of fluid of development of abnormal new blood vessels on the surface of the retina. It usually affects both eyes.
Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways:
Who is at risk for diabetic retinopathy?
All people with diabetes — both Type I and Type II — are at risk. That’s why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. The longer someone has Diabetes, the more likely he or she will get Diabetic retinopathy. About 70 per cent of people diagnosed with Diabetes have some stage of Diabetic retinopathy. If you have Diabetic retinopathy, your doctor can recommend treatment to help prevent its progression.
Better control of blood sugar levels slows the onset and progression of retinopathy. The people with Diabetes who kept their blood sugar levels as close to normal as possible also had much less kidney and nerve diseases. Better control also reduces the need for sight-saving laser surgery.
Other studies have shown that controlling elevated blood pressure and cholesterol can reduce the risk of vision loss. Controlling these will help your overall health as well as help protect your vision.
Symptoms: Often there are no symptoms in the early stages of the disease, nor is there any pain. Don’t wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year.
Blurred vision may occur when the macula — the part of the retina that provides sharp central vision — swells from leaking fluid. This condition is called macular edema.
If new blood vessels grow on the surface of the retina, they can bleed into the eye and cause loss of vision. At first, you will see a few specks of blood, or spots, floating in your vision. If spots occur, see your eye care professional as soon as possible. You may need treatment before more serious bleeding occurs. Hemorrhages tend to happen more than once, often during sleep.
Sometimes, without treatment, the spots clear, and you will see better. However, bleeding can reoccur and cause severely blurred vision. You need to be examined by your eye care professional at the first sign of blurred vision, before more bleeding occurs.
If left untreated, proliferative retinopathy can cause severe vision loss and even blindness. Also, the earlier you receive treatment, the more likely treatment will be effective.
Treatment: During the first three stages of Diabetic retinopathy, no active treatment is needed, unless you have macular edema. However regular eye checkups and good control of blood sugar, blood pressure and blood cholesterol is a must to prevent further progression of the disease.
Proliferative retinopathy is treated with Laser treatment. This procedure helps to shrink the abnormal blood vessels. Laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams.
If the bleeding is severe, you may need a surgical procedure called Vitrectomy. During vitrectomy, blood is removed from the center of your eye.
Once you have proliferative retinopathy, you always will be at risk for new bleeding. You may need treatment more than once to protect your sight.
The writer is Dr Arundhati Kar, Senior Eye Surgeon and Director, CDAS Hospital, Gurgaon
Look out for
Diabetic foot is an outcome of complication of long standing Diabetes mellitus. Most common cause being the highest chances of getting foot infections leading to boils or unhealed ulcers with cellulitis.
Diabetic foot refers to the array of mixed pathologies.
Diabetes patients have 25 per cent lifetime risk of developing foot ulcers and as per global estimates every year 1 million Diabetes patients do undergo amputations. The mortality rate following amputations is also very alarming which scales up 0to 15-40 per cent at one year and 39-80 per cent at five years. Diabetic neuropathy carries seven- fold higher risk of non-healing diabetic foot ulcers.
Most common triad cause of diabetic foot ulceration is — neuropathy, deformity and trauma.
Most of the Diabetic foot ulcerations are being classified as Neuropathic, neuroischemic and ischaemic.
Most related conditions associated with an increased risk of amputation are:
Neuropathic Diabetic foot ulcers are seen mostly on the plantar surface of foot at high pressure point and are identified by loss of sensation and sweating in that areas and is mostly painless.
The writer is Dr Tangi Rajdev Patro, Chairman & HOD, Diabetology, CDAS Hospital