Diabetes: More Than a Numbers Game

Diabetes: More Than a Numbers Game

Imagine you’ve been diagnosed with diabetes. It’s scary and a lot of information is coming at you all at once. It seems like it is all about watching those numbers. Lose a few pounds and things look better. Track your blood sugar levels and you’re okay. Set aside time throughout your day for physical activity, and you notice improvements. However, there is more to it than just tracking the numbers.

How familiar are you with diabetes? Well, let’s build a little base knowledge on this. Diabetes is a complex metabolic condition where your body struggles with the production or use of insulin, a hormone that manages glucose (blood sugar) levels. Glucose levels can increase because your body doesn’t have enough insulin to break down the sugars in your bloodstream. The opposite can happen too. High or low blood sugars have negative effects on all parts of your body. How does this relate to your eyes? Simple, if your blood sugar levels fluctuate so can your vision. Changes in blood sugar levels can cause your natural crystal clear lens to swell and lose the ability to maintain a sharp focus. Temporary blurred vision is a common symptom for people with diabetes. This typically means their blood sugars are not in the normal range. Taking regular blood sugar measurements provide great data for you to manage your diabetes.

The magic number that can assist a large part of managing diabetes with your care team is your A1C. This is a simple blood test that provides a vast amount of information. A1C test results are reported in percentages measuring your average blood sugar level over the past three to six months. The goal for most patients is to keep it less than seven percent. Anything higher than that can increase your risk of developing diabetic-related eye disease.

Even if all your numbers are stable, it is important to schedule and keep your annual dilated eye exam. Your optometrist is a crucial member of your care team and will look for signs of eye damage specific to diabetes. Dilating your eyes gives optometrist a larger viewing window and to get high-quality pictures and scans. They may use a special camera or imaging device to photograph the retina and look for signs of diabetes-related damage. 

Consistently high blood sugar levels can damage the tiny blood vessels, capillaries, in the retina, the light-sensitive tissue in the back of the eye. This causes the capillaries to leak fluid or hemorrhage (bleed). Your body can attempt to compensate for this by growing new and weaker blood vessels. These vessels can bleed into the center of the eye, lead to scarring, or cause dangerously high pressures inside your eye. This is referred to as diabetic retinopathy.

A condition called macular edema can occur when the capillary walls can no longer control the passage of substance between the blood and the retina. Fluid can leak into the macula, part of the eye where focusing occurs.

There are two main forms of treatment for diabetic eye disease. The first is laser treatment or sometimes referred to as laser photocoagulation. A retina specialist will target leaking blood vessels by “spot welding” and sealing the area of leakage. The second form of treatment would be eye injections. A retina specialist will inject medication into the eye – either directly or in the form of an injectable implant. Injections are usually recommended over laser treatments. 

Diabetes is a complex metabolic condition and requires a great care team. It may appear to be all about watching those numbers, losing a few pounds, monitoring your blood sugar levels, and setting aside time throughout your day for physical activity. But it is so much more than a numbers game. At Mabee Eye Clinic, our doctors are prepared to help continue and manage care with your primary medical doctor. We have a unique exam set up for patients with diabetes. A comprehensive eye exam with dilation and specialized tests to document and note subtle changes related to diabetes. We also send our results and findings to your medical doctor establishing that complete care you need. If you have been recently diagnosed with diabetes or wish to switch or continue your care with us, please call (605) 996 – 2537 to schedule your appointment today.

References

Understanding A1C. American Diabetes Association. Retrieved October 5th, 2020, from https://www.diabetes.org/a1c

Piertrangelo, A., Potter, D., & Basina, M. (2020). What you need to know about diabetes and blurry vision.  Healthline. Retrieved October 5th, 2020, from https://www.healthline.com/health/diabetes/blurry-vision#diabetes-and-eyes

Dubow, B. (2016). Diabetes and diabetic retinopathy.  All About Vision. Retrieved October 5th, 2020, from https://www.allaboutvision.com/askdoc/diabetes.htm

(2017). Diabetes eye disease.  National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved October 5th, 2020, from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-disease

Haddrill, M. (2019). Diabetic retinopathy treatment (and macular edema).  All About Vision. Retrieved October 5th, 2020, from https://www.allaboutvision.com/conditions/diabetic-treatment.htm

Haddrill, M. (2019). Diabetic retinopathy, diabetic macular edema.  All About Vision. Retrieved October 5th, 2020, from https://www.allaboutvision.com/conditions/diabetic.htm