Diabetic Retinopathy

Diabetic Retinopathy speaks to how Diabetes will impact the small or fine Blood vessels of the Retina over time where they become damaged and eventually leak. As it advances the person will become often aware for the first time that their vision is blurred and or distorted. I had before mentioned that Diabetes is the leading cause of vision loss in the under 50 group and leads over the age paradigm 20 thru 70. You are time and again going to find Glaucoma in Diabetics Weather Diabetes as a causative predisposition for Glaucoma no longer exists by current fact; the assertion remains the same with Diabetes as all to often with Glaucoma that once initially diagnosed damage has already occurred. Again. Recall 50% of people with Glaucoma have no knowledge of their disease. Just to add to the above the controversy is that Diabetes may evoke the release of Anti vegs that are neuroprotective yet current work at Doheny Eye in California puts diabetes back on the Glaucoma Risk Factor list. Oddly both may hold merit neuroprotection but at the same time blood flow impaired dynamics? Works for me!

With the Diabetic this already occurred damage, is all too often sizable. So if you walk around with Diabetes unmanaged or undetected you are at risk of cardiovascular changes, neuropathy and loss of sight. As touch on before you can modulate your BMI body mass index through diet and exercise.BMI is a measure of weight related to height and the computed number can have relevance to Cardiovascular Disease risk.

The Physicians Health study of some 5010 men middle age and older found that a BMI of greater than 28 increased the likely hood that the subjects would have high blood pressure and/or Diabetes.

The Canadian Diabetic Association wants you to Know that Diabetics number about 2 Million in their last data but gave notice the number would be 3 Million in 2010 which is of course now and not when I started reaserching this website. Half of which do not know they have it. A further insight born in the year 2000 or there after and based on current lifestyle demographics you are at a 1/3 possibility of experiencing Diabetes in your lifetime. Why so? Everybody out there for the most part lives longer so they have the logical proportional increase that comes with age. Obesity we eat the wrong stuff and too much of it and we ride rather than walk. We spend entirely too much time at sedentary tasks like accessing the Internet. The Family Practice Optometrist (O.D.) the Generalist of Eyecare may discover your Diabetes tendency first before you ever seek out a Family Practice Medical Practitioner (M.D.) by your visual complaints elicited in a careful History taking; and by taking into account the pre-disposing factors of lifestyle and inheritance. Namely siblings and close relatives with Diabetes. The Optometrist may have made an investment in a Digital Retinal Camera as I have done in both Clinics and can actually document for the first time changes in the back of your eyes and then again maybe none show at this juncture. This same device will prove invaluable going forward in your care as the doctor will not have to rely solely on drawings but can employ stereoscopic (3D) comparisons.

I again had to insert that our clinics now have the MRI for the eye the OCT and can demonstrate the swelling unmanaged blood sugars have on retinal tissue thru a SCAN. You may be pre-Diabetic a A1c of 5.7 to 6.4 % or higher. Probably higher but not as high as one would think to evoke a change in Clarity of Vision and Refractive status. Drawing from info provided by The Mayo Clinic in performing a A1c a Glycated Hemoglobin test what is being investigated is the blood average serum level over the last 2 to 3 months. In other words it tracks your blood sugar and is a means of asserting how successful a person is in managing their Diabetes. It is also used as one amongst other tests for Diagnosing type 1 and type 2 diabetes. Where pre diabetic ranges from 5.7 to 6.4%. The Normal range is 4.5 to 6 %. If you run 6.5% or higher on 2 or more occasions you are determined to be Diabetic. If your A1C is 3.9 % you certainly are Hypoglycemic and the cause of this warrants investigation .A Managed Diabetics A1C is targeted to and below 7%. Currently according to Mayo persons with a B.M.I. of 24 or Higher need testing. What invalidates an A1c is blood transfusion, Hemolytic anemia and Different or Variant Hemoglobin type with varied binding characteristics. Just with knowing how Blood Pressure/ Pulse rate affects the Pt suitability of certain Glaucoma Meds Every Optometric first line Practitioner should know these approximate A1c levels so they can question their Diabetic patients under their scrutiny. In the same way they can question their patients about the success of their cholesterol management. The Optometrist might be the first liner to discover a state of elevated cholesterol by the appearance of Fundi vessels or the greater incidence of Soft Drusen in a younger person of atypical retinal presentation. Photo documentation allows for comparison such that the clinician finds that Retinal findings are getting worse rather that unchanged over time. Possibly this could assert that the Diabetic is not doing a good enough job in the management program or treatment needs modulation.