Diabetic retinopathy is a chronic complication of diabetes resulting in serious visual impairment and blindness. The classic symptoms of this disease include increased thirst, frequent urination, weight loss, and lack of energy. Diabetes attacks the small blood vessels of the body that help supply blood and nutrients to the brain, peripheral nerves, kidneys, and eyes.
In the eye, diabetes can cause the blood membranes to thicken. Also, the number of eye cells in the retina to dwindle, hampering their ability to carry oxygen and nutrients to retinal tissue. Coping with Diabetic Retinopathy may take its toll on the whole body and it, therefore, becomes important to undertake early preventive steps in order to avoid major complications in advanced stages.
Preventing diabetic retinopathy
Diabetic retinopathy is often a two-stage process- non-proliferative and proliferative diabetic retinopathy. Simply put, the longer the person experiences diabetic symptoms and poor metabolic control. Therefore, the higher are the chances of developing diabetic retinopathy. It is also important to understand why the onset of diabetes is particularly troublesome for your eyes. Research indicates that high blood glucose leads to high glucose levels in the retinal cells, since the sole glucose transporter to retinal cells (also called GLUT 1), becomes hyperactive in case of increased blood sugar. This is the ultimate cause of diabetic retinopathy.
Thus, lowering your risk of eye complications from diabetes depends on a lot of controlling your blood sugar. Research indicates that in people with Type I diabetes, intensive insulin therapy at regular intervals results in the delay in progression of diabetic retinopathy. Keeping a watch on blood sugar along with proper medication/insulin injections and careful diet. Therefore, prove to be useful in preventing vision problems emanating from this disease.
Apart from this, serious complications in retinal cells could also arise due to an increased blood pressure, obesity and infections- often the precursors to diabetic retinopathy. Ophthalmologists usually recommend controlling your weight and blood pressure and attending to infections if any. Though not always easy, such control is certainly possible to achieve. It is also preferable to get a routine eye examination at least once a year.
Further, it is also known that a majority of people with Type-2 diabetes are at a very high risk of developing diabetic retinopathy. Unlike Type-1, Type-2 diabetes is caused because of the inability of the body to utilize insulin properly and is very common amongst patients (90-95% of the total cases of diabetes). Multifactorial therapy aimed at changes in lifestyle and optional glycemic control is known to reduce the risk of Type-2 diabetes resulting in diabetic retinopathy.
Glycemic, lipid and blood pressure control has proven effects on the progression of diabetic retinopathy. Other preventive strategies also include anti-VEGF (anti-vascular endothelial growth factor) agents, intensive combination therapies and use of anti-inflammatory agents.
These primary preventive strategies are the lists in detail below
1. Blood Pressure Control
Hypertensive diabetes increases the retinal pressure responsible for the progression of diabetic retinopathy. Strict control of your blood pressure thus significantly reduces visual loss and progression of retinopathy. In order to counter blood pressure, anti-hypertensive drugs may also be taken.
2. Lipid Control
Elevated levels of lipid (also called as dyslipidemia) are also one of the triggering factors of diabetic retinopathy. Lipids are hydrocarbon containing parts that form the building blocks of cells. There exists a positive correlation between dyslipidemia and worsening of diabetic retinopathy.
3. Anti-VEGF agents
Sometimes, VEGF agents result in retinal neovascularization (natural formation of blood vessels in the eyes). Anti-VEGF factors reduce such VEGF formation and are effective in the treatment of diabetic macular oedema.
Some other early preventive techniques that you could adopt include-
There exists a strong correlation between stress and vision. Stress can cause weakening of the immune system leading to a host of other problems. Further, lack of breathing in stressful conditions can hamper the flow of oxygen to retinal cells and lead to the release of cytokines resulting in inflammation in the eyes. Apart from this, there is evidence for increased risk macular degeneration, macular oedema and cataracts.
Maintaining a healthy and balanced diet is one of the most crucial factors in preventing diabetic retinopathy. The retinal and macular portions of the eye contain different nutrients. For example, lutein and zeaxanthin which drain over a course of time because of ageing and poor sustenance. Consequently, having an eating routine rich in anti-oxidants, vitamin A and C and other supplements like omega 3 fats, copper and zinc will help a great deal in preventing such diseases.
The wide-ranging benefits of exercising include maintaining the blood pressure within limits, which is helpful in reducing the risk of damage to retinal cells. One could undertake basic cardiovascular exercises like running, swimming or even practice yoga to keep your eyes healthy and sharp.
Dr Babak Shabatian, MD, is an ophthalmologist and founder and director of Cali Eye and Laser Institute. He has performed thousands of procedures with excellent and predictable results. He is frequently invited to lecture on topics of refractive and advance cataract surgery.