Diabetes and The Eye

Posted on

Oct 08, 2019

Diabetes is the leading cause of blindness among people between 25 74 years old.
Half of people with diabetes are unaware they have it. Of those who are aware only 50% get appropriate eye care.
Most people think that blood sugar levels are the most important risk factors for vision loss in Diabetes Mellitus. However, blood glucose control only accounts for 10% of the risk of vision loss in DM.
Other factors such as sleep apnea, hypertension and kidney disease impact vision risk in a diabetic individual.
There is a complex relationship between the nervous system, the immune system and the circulatory system. These 3 systems interplay in a way which both predicts and allows early diagnosis and effective treatment.
New diagnostic modalities include:

Wide-field retinal photography and artificial intelligence screening applications.
Non-invasive OCT angiography (OCT-A)
Electrophysiologic testing for retinal function (ERG)

These tools allow early diagnosis and treatment with medications designed to limit the growth of abnormal blood vessels in the eye and the swelling of sensitive retinal tissue.
The eye manifest changes in several ways:

Diabetic retinopathy with leakage and abnormal vessel growth.
Bleeding into the gel cavity of the eye (vitreous hemorrhage).
Cataracts may occur as a result of fluctuation in blood sugar.
Diabetics are at a higher risk of optic nerve swelling due to lack of blood flow to the optic nerve.
Double vision is more common in diabetics due to lack of blood flow to the nerves controlling the eye muscles.
Glaucoma occurs 2x more frequently in diabetics.
Carotid artery narrowing is more common in diabetics. This can lead to stroke.
Diabetics are more susceptible to corneal ulcers, dry eye and eye pain.

The data is convincing, the longer one has had DM, the greater the chance of developing eye related complications.
Keys to avoiding eye problems in people with diabetes include:

Regular eye examinations
Hemoglobin A1C levels <7
Controlled hypertension
Appropriate cholesterol levels
Avoidance of smoking
Efforts to control obesity



Editors Note:This article was submitted by Alan Margolis, MD.
Dr. Margolis is an ophthalmologist at Margolis Vision and may be reached at 303-797-1150.

Other Articles You May Like

Top Tips for Preventing Diabetic Eye Disease

Those with diabetes have their hands full when it comes to effectively managing the disease. From lifestyle changes to medication management and a plethora of medical appointments, tests, and procedures, keeping diabetes in check requires both ongoing education and dedication to following doctors orders.November is Diabetic Eye Disease Month, the perfect time to address this additional facet of diabetes care. You may have heard frightening statistics that link diabetes with blindness, but the truth is, most people with diabetes are at risk for less severe vision problems. However, its important for diabetics and those who care for them to be vigilant in keeping up with eye exams and addressing any concerns that arise immediately.Following are a few of the leading eye conditions that may affect someone with diabetes, according to the American Diabetes Association:Cataracts: The risk of cataracts is 60% more common for those with diabetes. Diabetics also are usually diagnosed with cataracts at a younger age than those without diabetes, and they typically progress faster, too. Mild cataracts can be managed by wearing sunglasses and glare-control lenses, while more developed cataracts will likely need to be removed.Glaucoma: Because diabetics are at a 40% higher risk of contracting glaucoma, its crucial to be screened routinely. The risk increases with age and with the length of time a person has had diabetes. Medications are available to reduce the pressure in the eye, and surgery may be an option as well.Retinopathy: The term retinopathy covers all disorders of the retina caused by diabetes, including the most common form, non-proliferative retinopathy, in which pouches form in the back of the eye, as well as proliferative retinopathy, in which blood vessels close off as the result of damage, causing new, weakened vessels to leak blood. Several different treatment options are available for both of these conditions, and as with other eye conditions, the quicker theyre treated, the better the prognosis.Home Care Can Help!At Home Matters Caregiving, our caregivers are skilled and experienced in helping those with diabetes follow doctors orders to remain in optimal health. Some of the many ways we can help include:Planning and preparing nutritious, diabetes-friendly mealsProviding transportation to the doctor or for any necessary proceduresOffering encouragement to participate in doctor-approved exercisesServing as a friendly companion to brighten each dayAnd much more

The Role of Exercise in Diabetic Senior Care

  For individuals diagnosed with diabetes, managing care can involve quite a few things to remember. As we age, these things become even more vital to our continued successful health maintenance.The most important aspect of our health management that we should always adhere to is exercise. No matter our age, being able to engage in physical and cardiovascular activities ensures that our diabetes remains manageable.What does this mean for seniors? For starters, it means keeping an open dialogue with your or your loved ones doctor to navigate what your body can handle in the way of physical exertion. Knowing where to start is half the challenge.Once you know your loved ones capabilities, you can encourage daily movement that translates into better health for them overall. With their diabetes under control, the other parts of their health, physical and mental, will fall into place.How Exercise Helps Manage DiabetesWith diabetes, the main concern is ensuring your body remains healthy and has no long-term adverse effects. Common health complications range from heart disease, chronic kidney issues, nerve damage, and other mental health concerns.How your loved one approaches diabetes depends on whether your loved one is Type 1 or Type 2. As many know, Type 1 is a direct result of your pancreas being unable to properly break down sugars in your blood, whereas Type 2 can go into remission with the right combination of diet and exercise.Therefore, one of the most significant factors in successfully maintaining positive health with diabetes comes from consistent exercise. Knowing the benefits of such actions will go a long way toward better understanding the why behind it and getting your loved one to participate actively.So, how does exercise help you and your loved one manage your diabetes? Here are some of the ways.Increases insulin sensitivity which makes the body more likely to absorb the hormone properlyControl blood sugar levelsKeeps blood pressure within the healthy rangeLowers LDL (bad) cholesterolHelps maintain a healthy weightImproved balance and flexibilitySleep betterFeel less stressedKeeping up with your overall physical health will, in turn, help you and your loved one manage your diabetes. After all, diabetes is a disease that affects all areas of your body.The next step toward this healthy goal is understanding what exercises will best benefit you and your loved ones.Exercise Suggestions for SeniorsA significant concern for many seniors revolves around mobility. Therefore, many are hesitant to remain active, fearing they might further hurt themselves.The good news is that you can easily find an exercise routine that works for you or your loved ones mobility strengths by communicating with your doctors and care team. Every exercise suggestion below can be adjusted based on your capabilities.Walking/Dancing  This exercise suggestion aims to get your whole body up and moving around. Your body will not only reap the benefits of keeping your muscles active, but this activity can help maintain a healthy weight, ensure better heart health, and lower blood sugar levels.Yoga  This is another exercise that gets your body moving while also helping to lower stress levels, which in turn helps manage diabetes care. Yoga helps reduce blood sugar levels, which can jumpstart your ability to maintain a healthy weight and continued body flexibility.Swimming  Getting in the water to exercise is accessible to just about anyone, regardless of abilities, and allows the health benefits from walking or yoga to be seen more effectively. The water makes movements low-impact, especially on your joints, which can ensure that flexibility and mobility increase.Daily Chores/Activities  This might be the easiest way for you or your loved one to get the exercise needed to manage your diabetes on the most basic level. Moving your body in any kind of way will help. Therefore, actively participating in everyday activities can go a long way toward positive health.No matter what kind of exercise you or your loved one chooses, make sure it remains consistent and achievable. It is recommended that you achieve 150 minutes of exercise a week, but do what works best for you.Diabetes care starts with good nutrition, exercise, and positive mental health. Knowing how to achieve each of these, especially exercise, means your loved one will continue to live a happy and healthy life.Keeping the Motivation AliveExercise is easy enough to achieve as long as you put the time in to discover the best course of action. However, individuals with diabetes are often working against their own mental health to stay on top of the proper care.One of the significant side effects of diabetes is depression and other negative mental health roadblocks. Therefore, it is essential to remember this when setting up an exercise routine for yourself or your senior loved one.You can ensure that motivation remains above all else in many ways. First and foremost is getting an exercise buddy to keep your loved one accountable for their daily movement goals.Having someone there to ensure accountability will go a long way toward your loved one maintaining a positive mental health outlook and their diabetes overall. This buddy can be someone who also has diabetes or at least knows what having diabetes means for you or your loved one.A professional caregiver can often be a great partner in focusing on personal health and wellness, especially regarding chronic conditions like diabetes. Many of our home health aides at Accessible Home Health Care can address various medical and non-medical needs, suitable for helping seniors remain active and get the assistance they need.If you believe your loved one would benefit from a caregiver to help them manage daily living with diabetes, let us know. We will work with you to arrange care in the comfort of their home.

Poor Sleep and Diabetes

Thirty-five percent of people report getting less than the recommended seven to nine hours of sleep nightly.[1] People who dont get enough sleep are prone to health problems, including type 2 diabetes. How sleep or lack of it affects diabetes is still being investigated, but its possible that for some people, preventing or controlling diabetes is as simple as getting an extra hour or two of zs each night. People who suffer from sleep disturbances are at risk for obesity, diabetes, and coronary artery disease, according to research from the Perelman School of Medicine at the University of Pennsylvania. The research analyzed data of over 130,000 people and indicated that general sleep disturbances such as difficulty falling asleep, staying asleep, or sleeping too long may play a role in the development of cardiovascular and metabolic disorders.[2] The study discovered a clear relationship between sleep disturbance and diabetes. The findings suggest that getting a better nights sleep may lead to better blood glucose control. Researchers at Cedars-Sinai Medical Center found that just one night of sleep deprivation can decrease insulin sensitivity equal to the effect of six months of a high-fat diet.[3] This could mean that for type 2 diabetics, getting enough rest could contribute significantly to managing blood sugar. Diabetes and sleep have a complicated relationship. The better we can manage the symptoms of diabetes the better our sleep should be. Exercise, healthy eating habits, proper rest, and regular doctor visits could be part of the process in managing the symptoms of type 2 diabetes.[1] Centers for Disease Control and Prevention. (2016, February 16). 1 in 3 adults dont get enough sleep. Retrieved July 15, 2020, from https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html[2] Grandner MA, Jackson NJ, Pak VM, Gehrman PR. Sleep disturbance is associated with cardiovascular and metabolic disorders. J Sleep Res. 2012;21(4):427-433. doi:10.1111/j.1365-2869.2011.00990.x[3] Obesity Society. Insulin sensitivity: One night of poor sleep could equal six months on a high-fat diet, study in dogs suggests. ScienceDaily. ScienceDaily, 4 November 2015. www.sciencedaily.com/releases/2015/11/151104134039.htm.