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Diabetes and the Eye

Diabetes is a tremendous problem for patients and the healthcare system in general. With over 20 million diabetics currently in the country and another 40 million with pre-diabetes, its easy to see this is a tremendous concern.

There are basically 3 different types of Diabetes, but perhaps there is a fourth type soon to be categorized. Type 1 usually starts in children but can occur at any age. These patients require daily injections of insulin. Type 2 makes up most of the cases of diabetes and usually occurs in adulthood. It has a high correlation to obesity but there are some thin patients who have this and in these people it may be genetic. Perhaps this type will one day be broken down to type 2a and type 2B. Finally there is gestational diabetes that develops during pregnancy in a woman who does not have diabetes. These patients frequently go on to develop diabetes Type 2 later in life, though not always.

So how does diabetes affect the eyes? Many patients have diabetes for years without any knowledge of the problem. When they are diagnosed, a baseline eye exam is mandatory. A thorough evaluation of the retina is important because there can be bleeding and swelling of the retina that does not effect vision, but will if left unchecked. Also, if there is “Diabetic Retinopathy” present, there may well be other complications of diabetes, such as kidney disease. The eye is the only place in the body we can observe the vascular bed in action. Systemic diseases, such as diabetes, do not just affect the eyes, but in the eyes we can get an idea of what is happening throughout the body.

Diabetics without any eye disease need to be seen once a year for a dilated exam. Patients who have good to excellent control of their blood sugars tend to have little eye disease. Studies have shown that ocular health is improved by tight control. Knowing your Hemoglobin A1C value is important and has a good correlation as to whether your eyes may be involved in the disease process.

Diabetics with retinopathy require more frequent evaluations and perhaps therapeutic interventions, including but not limited to laser treatments, injections and surgery depending on the extent of their retinopathy. Today’s treatments have saved the sight of diabetics who even 15-20 years ago would have lost their vision.

We can’t drag you in for an evaluation, but if you are diabetic, you owe it to yourself and your family to have a dilated examination with a qualified physician!

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