Tag: diabetic retinopathy

Diabetes A1C Test

Karen Griffith

Diabetes illness concepts word cloud illustration. Word collage concept.

What is a diabetes A1C test? The hemoglobin A1C is a blood test that is a regular part of diabetic care. It is done every 3-4 months. The benefit of the A1C test is that it provides a measure of how your blood glucose levels have averaged over the past 2-3 months and provides a “picture” of overall blood sugar control. Sugar builds up in your blood and combines with your hemoglobin, becoming “glycated,” the average amount of sugar in your blood can be found by measuring your hemoglobin A1c level.

The daily blood glucose checks that are done at home or in the doctor’s office measure the blood glucose level at that moment. The A1C test measures the blood sugar over time and is extremely important for monitoring how well your diabetes is controlled.

For people without diabetes, the normal range for the hemoglobin A1c test is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% indicate increased risk of diabetes, and levels of 6.5% or higher indicate diabetes. Because studies have repeatedly shown that out-of-control diabetes results in complications from the disease, the goal for people with diabetes is a hemoglobin A1c less than 7%. The higher the hemoglobin A1c, the higher the risks of developing complications related to diabetes.
One of these complications due to high blood sugar is diabetic retinopathy. Since diabetes primarily affects the blood vessels, it is very important to have a dilated eye examination at least once a year. The retina inside the eye is the only place in the body where blood vessels can easily be examined.

How Does Diabetes Damage Your Eyes?

Karen Griffith

November is Diabetes Awareness month. High amounts of blood sugar can harm the internal structures of the eye. Below are some of the things that diabetes can do to the eyes.

  • Blurry or Double Vision. Fluctuating blood sugar and fluctuating vision are connected. A change in glucose levels affects the eye’s ability to maintain sharp focus. It may take several months after your blood sugar is well controlled for your vision to stabilize.

 

  • Diabetic Retinopathy. The leading cause of diabetes-related vision loss is diabetic Diabetic Retinopathy retinopathy. This condition damages the network of blood vessels supplying the retina with blood and oxygen. It also causes abnormal growth of blood vessels on the retina. When these vessels leak they damage  the retina causing permanent vision loss.
  • (the picture on the left is an example of fluid and blood leakage in diabetic retinopathy.)

 

 

  • Cataracts. People with diabetes have a much greater risk of developing cataracts and at an earlier age. A cataract is clouding of the eye’s natural lens and results in glare and obscured vision.
  • Glaucoma. Diabetes also increases your risk of developing glaucoma. This condition results from an increase in fluid pressure inside the eyeball, which causes damage to the retina and optic nerve. If untreated, glaucoma leads to gradual but permanent vision loss.

Actions to take right now include the following: Eating sensibly, the American Diabetes Association recommends filling half your plate with vegetables, a quarter of the plate should be lean protein and the rest a carbohydrate. Make time for 30 minutes of exercise everyday. Take your medicine as prescribed and know your blood sugar level.

Preventing diabetes is the best way to avoid diabetic damage to the eyes, but if you already have diabetes, regular eye examinations can prevent permanent damage to the eye due to elevated blood sugar.

 

How does Diabetes Damage the Eyes?

Karen Griffith

Vision Loss

Over time uncontrolled blood sugar and poor circulation can harm the internal structures of the eye.
Blurry or Double Vision
Fluctuating blood sugar and fluctuating vision are connected. A change in glucose levels affects the eye’s ability to maintain sharp focus. It may take several months after your blood sugar is well controlled for your vision to stabilize.
Diabetic Retinopathy
The leading cause of diabetes-related vision loss is diabetic retinopathy. Diabetic retinopathy can damages the network of blood vessels supplying the retina or cause the growth of  abnormal  blood vessels on the retina. When these fragile blood vessels leak, the fluid and blood damage the retina and can cause permanent vision loss.
Cataracts
People with diabetes have a much greater risk for developing cataracts and at an earlier age. A cataract is clouding of the eye’s natural lens and results in the inability to focus light, glare and compromised vision,
Glaucoma
Diabetes also increases your risk of developing glaucoma. Glaucoma causes irreversible damage to the retina and optic nerve. If untreated, this damage leads to vision loss.

Scheduling regular eye exams can help detect diabetes-related eye diseases before they cause irreversible damage.
Exercise, a healthy diet and keeping glucose levels and blood pressure controlled can also help control eye problems.

Diabetic Awareness Month

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If you have diabetes, it requires attention every day of the year, not just the month of November. But I am going to take advantage of Diabetes Awareness Month to remind you that your eyes are important and can be significantly impacted by diabetes.
First and most important, keep your blood sugar levels under tight control. In the Diabetes Control and Complications Trial, people on standard diabetes treatment developed retinopathy four times as often as people who kept their blood sugar levels close to normal. In people who already have retinopathy, the condition progressed in the tight-control group only half as often.

Diabetic Retinopathy

These impressive results show that you have a lot of control over what happens to your eyes. Also, high blood sugar levels may make your vision temporarily blurry.

Second, keep blood pressure under control. High blood pressure can make eye problems worse.

Third, quit smoking.

Fourth, see your optometrist at least once a year for a dilated eye exam. Having your regular doctor look at your eyes is not enough.

Fifth, see your optometrist if:

your vision becomes blurry
you have trouble reading signs or books
you see double
one or both of your eyes hurt
your eyes get red and stay that way
you feel pressure in your eye
you see spots or floaters
straight lines do not look straight
you can’t see things to the side as you used to

Don’t procrastinate. If you have diabetes and haven’t had a dilated eye exam in the last 12 months, schedule an eye exam now.

Diabetic Retinopathy Continued

admin

This is a continuation of my last blog post about diabetic retinopathy. I want to stress that diabetic retinopathy is the number 1 cause of new cases of blindness for adults 20-70 years old. The increasing number of people with diabetes means the number of people who will develop diabetic retinopathy will also increase. This is significant because severe vision loss can be prevented 90% of the time.

It is my job as an optometrist to identify and detect diabetic retinopathy. When I see diabetic retinopathy, I have to decide when to refer for further evaluation and/or treatment.

PREVENTING VISION LOSS

The most important thing you can do to prevent vision loss from diabetes is have a dilated eye examination every year.
If you notice changes in your vision or it seems blurry, call your eye doctor immediately. To read more about preventing eye complications from diabetes click here.

TREATMENT

If I think treatment is indicated, I will refer you to a retinologist. A retinologist is an ophthalmologist, who treats conditions of the vitreous and retina, both effected by diabetic retinopathy. He or she will chose the best treatment option.

A laser may be used to stop blood vessels from leaking. It may also be used over a larger part of the retina to reduce the growth of abnormal blood vessels. Laser maintains sight, but the side effects can include, blind spots in the vision and reduced vision.

Corticosteroid injections into the eye provide a temporary treatment. To maintain control of the retinopathy, repeated injections are necessary every 6-8 weeks. The continued use of corticosteroids increases the risk of developing cataracts and glaucoma.

Another treatment is the injection of anti-vascular endothelial growth factor (anti-VEGF) to prevent the blood vessels from leaking. This treatment also needs to be repeated every 6-8 weeks.

The retinologist will often use a combination of the above treatments to yield the best results.

Researchers continue to look for therapies with long-term results and minimal side effects.

Diabetic Retinopathy

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Westside Optometry continues to recognize November as Diabetes Awareness Month, although diabetes is something that deserves attention all 365 days of the year.  If you have diabetes, I will dilate your eyes at least once a year. Diabetes can affect many organs of the body, in the eyes it causes blindness.

Many problems develop in the retina due to diabetes. The possibilities include abnormal blood vessel growth, hemorrhages and lipid leakage. If these problems are allowed to continue without treatment they will cause scarring which leads to detachment of the retina. Another complication is the leakage of fluid under the macula which will severely reduce vision.

Not all these conditions will have symptoms. Only when the bleeding or fluids reach a certain size will you notice blur or dark spots. The earlier changes in the retina are detected, the better treatment results will be.

The picture above shows some of the changes diabetes causes in the retina. There is bleeding and some areas where blood isn’t flowing properly (ischemia). This patient did not notice any changes in his vision. If you have diabetes, don’t wait until you have vision changes, it may be too late.

How to Prevent Eye Complications due to Diabetes

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There are steps you can take to avoid eye problems due to diabetes.

First and most important, keep your blood sugar levels under tight control. In the Diabetes Control and Complications Trial, people on standard diabetes treatment got retinopathy four times as often as people who kept their blood sugar levels close to normal. In people who already have retinopathy, the condition progressed in the tight-control group only half as often.

These impressive results show that you have a lot of control over what happens to your eyes. Also, high blood sugar levels may make your vision temporarily blurry.

Second, keep blood pressure under control. High blood pressure can make eye problems worse.

Third, quit smoking.

Fourth, see your optometrist at least once a year for a dilated eye exam. Having your regular doctor look at your eyes is not enough.

Fifth, see your optometrist if:

  • your vision becomes blurry
  • you have trouble reading signs or books
  • you see double
  • one or both of your eyes hurt
  • your eyes get red and stay that way
  • you feel pressure in your eye
  • you see spots or floaters
  • straight lines do not look straight
  • you can’t see things to the side as you used to

Don’t procrastinate. If you have diabetes and haven’t had a dilated eye exam in the last 12 months, schedule an eye exam now.

For more information, check out the American Diabetes Association.

 

 

 

 

Diabetic Retinopathy

admin

In the previous blog post I wrote about the reasons I dilate patient’s eyes. If you have diabetes, I will dilate your eyes at least once a year. Diabetes can affect many organs of the body, in the eyes it causes blindness.
Many problems develop in the retina due to diabetes. There is abnormal blood vessel growth, hemorrhages and lipid leakage. If these problems are allowed to continue without treatment they will cause scarring which leads to detachment of the retina. Another complication is the leakage of fluid under the macula which will severely reduce vision.
Not all these conditions will have symptoms. Only when the bleeding or fluids reach a certain size will you notice blur or dark spots. The earlier changes in the retina are detected, the better treatment results will be.

The picture above shows some of the changes diabetes causes in the retina. There is bleeding and some areas where blood isn’t flowing properly (ischemia). This patient did not notice any changes in his vision.

What is Diabetes?

admin

November is Diabetes Eye Disease Month.  Before discussing how diabetes effects the eyes, I want to begin with the disease itself. Approximately 16 million Americans have diabetes. Classified as a “chronic disease epidemic” by the Centers for Disease Control and Prevention, the prevalence of diabetes has increased dramatically over the past forty years.

The term “diabetes mellitus” refers to a group of diseases that affect how your body uses blood glucose, commonly called blood sugar. Glucose is vital to your health because it is the main source of energy for the cells that make up your muscles and tissue. Glucose comes from two major sources: the food you eat and your liver. During digestion, sugar is absorbed into the bloodstream. Normally, sugar then enters cells with the help of insulin. If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.

There are different classifications of diabetes. 2 types are potentially reversible. Prediabetes is defined by having blood sugar levels that are higher than normal, but not high enough to be classified as diabetes and gestational diabetes, which occurs during pregnancy. Chronic diabetes conditions include type 1 diabetes which is caused when your immune system attacks and destroys the insulin-producing cells in the pancreas and type 2 diabetes which is caused when your cells become resistant to the action of insulin and sugar builds up in your bloodstream.

Diabetes is a chronic, complex and destructive disease that can cause a wide range of problems including heart disease, kidney failure, amputations and blindness. Both types of chronic diabetes, Type 1 and Type 2 are serious diseases, and can lead to the same kind of complications. But people with diabetes can take several steps to stay well. Most important are eating a healthy diet, exercising regularly, maintaining close control of blood sugar levels, and learning as much as possible about living with diabetes. By taking care of yourself through diet, exercise and special medications, diabetes can be controlled.