Many people believe that our eyes are the windows to our souls, revealing hidden truths about us. Not only are our eyes expressive of our emotions, but they're also a fantastic way to diagnose early signs of various health conditions. One of the most common diseases the eyes draw attention to is diabetes. This eye care blog takes a closer look at the ins and outs of diabetes and eye health, how to prevent eye damage, and warning signs that may indicate your body isn't managing as well as you may think with your diabetes.
• What is diabetes?
• Diabetes and eye health
• How diabetes affects the health of your eye
• Tips for good eye health in diabetics
What is Diabetes?
Simply put, diabetes is a chronic disease that impacts the way your body converts food into energy. Our bodies use the foods we eat to create fuel that helps us stay energized and moving throughout the day. Our body converts most of the food we eat into sugar, also known as glucose, and then transports it throughout our bodies through our bloodstream. This action causes our blood sugar to rise, triggering our pancreas to release insulin. Insulin sends a signal to our body's cells to accept the glucose, which is then used as fuel to create energy.
For people with diabetes, the problem lies with the body's insulin production and use. In a diabetic person, the body either doesn't produce enough insulin or doesn't use the insulin it creates effectively. When cells don't know to absorb insulin, the bloodstream becomes oversaturated with glucose. For short periods, this isn't particularly problematic. However, over time, high glucose levels can lead to serious health problems, including kidney disease, heart disease, and vision loss
According to the United States Centers for Disease Control and Prevention (CDC), over 34 million adults in the United States have diabetes, and 20 percent of them are undiagnosed. In the United States, diabetes is the seventh most prevalent cause of death and the number one cause of lower-limb amputation, kidney failure, and adult blindness.
Types of Diabetes
There are three types of diabetes: type 1, type 2, and gestational diabetes. Type 1 diabetes is less common than type 2 and is typically diagnosed early in life. Although eye care doctors don't know how to prevent type 1 diabetes, you can manage its impact on your eye health by living a healthy lifestyle, meeting regularly with your doctor, and maintaining safe blood sugar levels. Eye care experts believe that an autoimmune reaction may cause type 1 diabetes, but that the presence of certain genetic traits and exposure to an environmental trigger may increase your risk. The autoimmune reaction causes your body to destroy insulin-producing beta cells located in the pancreas. Unfortunately, beta cells can be under attack for months or years before diabetic symptoms begin.
In people with type 2 diabetes, the body's cells develop insulin resistance, preventing them from responding normally when glucose levels rise. In response, the body produces more blood sugar to trigger a reaction in the cells. Of the 34 million Americans with diabetes, more than 90 percent have type 2 diabetes. Although this type is traditionally seen in people over age 45, the number of younger people being diagnosed is also rising.
The third type, gestational diabetes, is a condition that develops in women during pregnancy who have not been previously diagnosed with diabetes. Between two and ten percent of pregnant women will develop gestational diabetes, though women with preexisting insulin resistance are at a higher risk. During pregnancy, the body undergoes several changes that impact weight gain and hormone production. These changes can impact the body's ability to use insulin correctly, producing insulin resistance. Although pregnant women typically have no lasting effects of diabetes past delivery, roughly half of women who experience gestational diabetes develop type 2 diabetes in the year following their pregnancy.
Diabetes and Eye Health
When it comes to protecting your eye health, all types of diabetics are at risk, especially if they're not managing their blood sugar levels appropriately. People with diabetes are at risk of developing a group of eye diseases if their blood sugar levels aren't controlled, including cataracts, diabetic macular edema, glaucoma, and diabetic retinopathy. If these conditions go untreated, they can cause permanent poor vision or even blindness.
Eye care doctors recommend the following tips to keep diabetic eyes healthy:
• Have a dilated eye exam annually
• Avoid smoking and tobacco products
• Manage the diabetic ABCs: blood glucose, blood pressure, and cholesterol
Diabetic eye health diseases typically cause little or no symptoms until extensive damage has already occurred, which is why it's critical to help manage your diabetes as well as attend annual eye care exams with your doctor. Dilated eye exams can help detect eye care issues as early as possible, allowing your doctor to treat the condition before vision loss occurs.
How Does Diabetes Affect My Eye Health?
Although it may seem odd, different systems within our bodies are tied together, giving eye care doctors a sense of what's wrong with one area based on the symptoms another part is experiencing. When it comes to eye issues for diabetics, the issue lies in the amount of glucose within the blood, also known as blood sugar. Although having short bouts of high blood sugar won't damage your eye health long-term, frequent, extended periods of high glucose levels can cause irreparable damage to your vision.
How does high blood sugar impact your vision? When your body experiences high glucose levels, it causes a change in fluid levels that cause swelling in the tissues that help your eyes focus. This swelling can lead to blurry vision. Many people with diabetes experience blurry vision during planned modifications to their medications or other diabetes care management changes. These instances of blurry vision are temporary, and vision returns to normal when glucose levels stabilize. However, if a person doesn't manage their medications correctly or aren't aware they have diabetes, permanent vision damage can occur.
Sustained levels of elevated blood glucose can damage the blood vessels in the back of the eyes permanently. Damage can occur as early as the prediabetes stage when blood glucose levels are elevated enough to cause concern but not yet high enough to be diagnosed as diabetes. Damaged blood vessels can cause swelling in the eyes as well as fluid leaks. In an attempt to repair itself, the body may attempt to grow new blood vessels. However, these vessels are often structurally weak and can cause unintended bleeding in the middle part of the eyes. This bleeding can increase eye pressure to dangerous levels as well as cause scarring.
Blood vessel damage is often the first sign of diabetic eye diseases. The four most common diabetic eye diseases that can cause permanent vision loss are:
• Diabetic retinopathy
• Diabetic macular edema
The retina is the inner lining in the back of the eyes. Its job is to translate light into signals that the brain then deciphers to make out the world around us. According to eye care experts at the American Academy of Ophthalmology, diabetic retinopathy is the damage of blood vessels in the retina due to high glucose levels. Damaged blood vessels can cause swelling, leaks, and abnormal blood vessels' growth on the retina. These blood vessels may also collapse, preventing blood from circulating.
Diabetic retinopathy occurs in two stages: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). NPDR impacts many people with diabetes and is the earlier stage of diabetic retinopathy. During NPDR, ocular blood vessels leak, causing swelling in the retina. PDR is the progression of the disease that causes the growth of weakened blood vessels on the retina's surface. People with diabetic retinopathy see dark splotches in their eyes that may partially or fully obstruct their line of sight.
The early stages of diabetic retinopathy can produce few or no symptoms, which means many people with diabetes go undiagnosed until symptoms worsen. As retinopathy progresses, symptoms can include:
• An increase in blurry vision
• Vision that transitions from clear to blurry and back
• Trouble seeing at night
• Seeing colors that appear washed out or faded
• Floaters or splotches in your vision
The optic nerve is located in the back of the eye and is responsible for sending messages to the brain. Glaucoma encompasses the group of eye health conditions that damage the optic nerve, leading to vision loss and blindness. Having diabetes doubles your risk of glaucoma, which is one of the many reasons it's crucial to manage your blood sugar properly.
Although there are several types of glaucoma, the most common is open-angle glaucoma. As with diabetic retinopathy, glaucoma typically begins without symptoms. That's why eye care doctors believe that roughly half of the people with the condition are unaware they're experiencing it. Glaucoma causes the loss of sight, typically starting with the peripheral vision located closest to the nose. The disease progresses slowly, and many people are unaware their vision is impacted until the damage becomes more extensive.
In addition to being common in those with diabetes, glaucoma is more likely to impact:
• Those of Irish, African American, Russian, Hispanic, Japanese, Scandinavian, or Inuit descent
• People over age 40
• Those with a family history of glaucoma
• Those on certain prescription steroids, including prednisone
• Individuals with thinner corneas
• Those that have high blood pressure, sickle cell anemia, or heart disease
• People with a history of injury to the eye or eyes
Glaucoma often impacts both eyes, although one may suffer more damage than the other. Unfortunately, once vision loss from glaucoma has occurred, there's no way to reverse the damage. However, eye care doctors can help save the existing vision by reducing pressure and following their eye health treatment plans.
Diabetic Macular Edema
The portion of your eye used for eyesight is the macula, a part of your retina. The macula helps with reading, distinguishing faces, and driving. Diabetes can create a build-up of fluid in the macula, a condition known as diabetic macular edema. This condition causes the macula to swell, damaging a person's eyesight's sharpness and producing partial or full vision loss. Diabetic macular edema is common in those already suffering from diabetic retinopathy.
People who suffer from macular edema experience wavy or blurry vision and faded or washed out colors. According to the National Eye Institute, diabetic macular edema is the leading cause of vision loss in those with diabetic retinopathy. Eye care experts believe roughly 750,000 people in the United States have diabetic retinopathy and diabetic macular edema. Research suggests that non-Hispanic African Americans are roughly three times more likely to suffer from diabetic macular edema than non-Hispanic Caucasians.
Our eyes contain lenses that help create clear and sharp eyesight. As we age, these lenses may become cloudy, causing a disease called cataracts. Over time, cataracts can create vision that is hazy, blurry, and washed out. Other symptoms include difficulty seeing at night, lights that seem too bright, seeing double, and seeing a halo around lights.
More than half of all people in the United States above age 80 are either suffering from cataracts or have had surgery to remove them. Although most cataracts are related to age and occur naturally, certain risk factors increase the likelihood of developing cataracts, including diabetes. Other risk factors include high alcohol consumption, taking steroids, smoking, high levels of sun exposure, having a family history of cataracts, and having eye surgery, eye injuries, or radiation treatments on your upper body. In addition to being more likely to occur in people with diabetes, people with diabetes also tend to develop cataracts at an earlier age.
Eye Health Tips for Diabetics
Although eye conditions can occur for various reasons, including age, trauma, and family history, the failure to manage your blood sugar levels can have a drastic impact on your eye health. Although it can seem scary to discuss potential eye care complications resulting from a diabetes diagnosis, arming yourself with the knowledge necessary to take the proper precautions is essential to the long-term protection of your vision.
If you've been diagnosed with diabetes, here are five crucial eye health care tips to help protect you from diabetic vision complications:
• Monitor your glucose numbers. High blood sugar can cause permanent damage to your eyesight, including changing the shape of the lenses in your eyes and causing blurry vision. Maintaining healthy blood glucose levels can help drastically reduce your risk of developing glaucoma, diabetic retinopathy, cataracts, and diabetic macular edema. If you notice your numbers rising, contact your eye care doctor immediately to determine a course of action to prevent vision damage.
• Wear your sunglasses. In addition to being fashion-forward, sunglasses help protect your eyes from UV exposure. Research shows that on top of diabetes, UVA exposure increases your risk of developing macular degeneration and cataracts. When shopping for designer sunglasses, make sure you select a pair that protects against UVA and UVB rays!
• Get into a fitness routine. Exercising regularly helps with glycemic control, one of the critical components in determining your likelihood of experiencing diabetic-related eye damage. Set a goal of exercising for 30 minutes a day at least three days each week. Start slowly if necessary, walking three times for ten minutes each or 15 minutes twice a day. It's essential to speak with your health and eye health providers before beginning an exercise routine to ensure you're not engaging in exercises that may strain the blood vessels in your eyes, especially if you are already experiencing eye problems.
• Quit smoking. Although smoking is harmful to everyone, it's especially harmful to those with diabetes. Although smoking doesn't directly increase the risk of diabetic eye health care problems, it can aggravate health issues that can trigger eye damage. People with diabetes are at an elevated risk of heart attack and stroke, and smoking increases that risk drastically. If you're a smoker and have tried unsuccessfully to quit or want to try for the first time, don't give up. Talk to your eye care doctor about resources that can help you quit smoking.
• Visit your eye care doctor for an annual dilated eye exam. An annual eye health exam that examines the health of your retina, lenses, and cornea can detect changes in your eyes that you may not notice otherwise. Talk with your ophthalmologist and be sure to request a comprehensive eye exam that includes a cataract test, glaucoma test, and a dilated eye exam. Many offices also offer retinal imaging. This technology helps doctors identify microscopic changes in eye health each year and compare them to one another to detect any changes. As a person with diabetes, it's crucial to contact your eye care doctor if you notice any changes in your vision. Don't wait until your next appointment to voice your concerns. These changes can indicate threats to your eye health that could become permanent if not treated in a timely fashion.
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