LIFESTYLE AND DIABETIC RETINOPATHY

The fact is that adult onset or type II Diabetes is reversible with lifestyle most of the time. Most people are aware that they can eliminate medications for this type of diabetes with lifestyle choices. Type I Diabetes however requires insulin therapy. Either type of diabetes can be associated with eye damage if the blood sugar is allowed to remain elevated.

Sugar is damaging to the small blood vessels in the eye, kidney and peripheral nerves. Over time the blood vessels develop microaneurysms, they leak blood and fat, and eventually they “drop out” or die. This leaves the retina with poor circulation and new blood vessels grow but they are harmful instead of helpful. If intervention either by better blood sugar control and or medical or surgical treatment is not done blindness can occur within 2 years.

Usually the damage take 7-15 years to occur. The recommendation is to keep the blood sugar between 70-120mg/dl and <180mg/dl after meals. Usually to accomplish this type of excellent control, multiple insulin injections per day or an insulin pump is required. One should work carefully with their physician to assure good blood sugar control.

The monthly exam or Hemoglobin A-1C should be kept <7 to prevent retinopathy.

Lifestyle reduces risk of retinopathy. In the Early treatment diabetic retinopathy study they found the lowering blood lipids(fats) decreased the risk of fat leakage into the retina which leads to visual loss.

Also patients with high blood cholesterol or elevated LDL had twice the amount of leakage into the retina compared to patients with normal blood levels.

9% of retinopathy occurs in non-diabetics related to elevated blood pressure, elevated cholesterol and triglyceride levels, elevated body mass index, and elevated waist to hip ratio.

Some medical references:

• Arch Ophthalmol/Vol 121(2) 2003, pp245-251
• Diabetes Care/Vol 25(8) 2002, pp1320-1325
• Arch Ophthalmol/Vol 114 1996 – ETDRS Study
• Diabetes Control and Complication Trial Research Group, 1993