Diabetes Mellitus Complication - Diabetic Retinopathy

Diabetic retinopathy is a serious complication of diabetes that may lead to irreversible blindness. Almost 80% of diabetic patients who suffered for 10 and more years are affected by this grave complication. But more recent research indicates that there are still a lot of things that can be done to treat diabetes and avoid the incidence of retinopathy. With adequate and attentive eye treatment and monitoring at least 90% of new cases of retinopathy can be reduced.



The retina is the most important inner part of the eye constructed by very specialized cells that function to receive light and convert it into an image. The retina then sends the image through the optic nerve to the brain where it is interpret accordingly.



The damage lies in small blood vessels (microvascular) of the retina. In type-1 diabetes retinopathy rarely develops before puberty, while in adults with type-1 diabetes, the incidence of retinopathy is also uncommon to appear before the fifth year of diabetes suffering. The progress of untreated diabetes goes inline with the damage of the retina. Hence it is very important to keep control on your blood sugar levels, since proper diabetes control will reduce the risk of developing retinopathy.



The Diabetes Control and Complications Trial (DCCT), a large medical study conducted on patients with type-1 diabetes by the United States National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) concluded that 50% - 75% of the respondents are less likely to develop diabetes microvascular complication that includes retinopathy, neuropathy and nephropathy. This successful group was provided with tight blood sugar control combined with the administration of insulin either through an insulin pump or multiple daily injections



Eye problems in patients with type-2 diabetes are mostly detected during a diagnosis of diabetes. In such cases routine control of blood sugar, blood pressure and cholesterol level is of major importance in anticipating the incidence of retinopathy and other eye problems



Types of diabetic retinopathy:



Background retinopathy is a damage of the retina blood vessel but it does not impair vision. At this stage you should vigilantly manage your blood sugar levels to avoid the progression to a more serious eye problem.



Maculopathy is a damage of the macula, a critical part of the retina that plays an important role in our vision ability. Since the damage affects the macula vision problem will be a major sign of the condition. In serious cases, vision is reduced significantly.



Proliverative retinopathy occurs when the retina blood vessels start thinning and occluded due to insufficient oxygen supply to the retina. New vessels will then be built to compensate the damage vessels. This condition may lead to retinal detachment which will seriously impair vision.



It is necessary to be aware of other risk factors that may deteriorate the obstructed vessels. Quit smoking, routine control of hypertension and blood sugar level, and cholesterol management are good attempts to stop the development of new vessels.



Treatment of diabetic retinopathy may include laser procedures or surgery. In a study of diabetic patients with an early stage of retinopathy, laser therapy to burn the fragile vessel was showing a result of a 50% reduction of blindness.



The prevention of diabetic retinopathy is through a routine eye screening on an annual basis. Diabetic women who later become pregnant should undergo a comprehensive eye examination during the first trimester and under a close supervision of an eye doctor during the rest of their gestation to avoid serious eye impairment. Just to remind you that this does not apply to women with gestational diabetes, since they are not at risk for retinopathy

Diabetes Mellitus Chronic Complications - What is Diabetic Retinopathy?

Diabetes is chronic disease which affects the major organs of the body, including the eye leading to diabetic retinopathy. The retina is the innermost layer of the eye and it is the part of the eye that is primarily affected in diabetic retinopathy. Diabetic retinopathy causes about 12,000 -24000 new cases of blindness in the United States alone and it is the leading cause of blindness amongst adults aged between20-74 years. It will affect most people with diabetes, the risk increases with the length of diabetes, the longer the diabetes, the higher the risk. Diabetic retinopathy leads to visual impairment and if not treated it leads to blindness, but loss of vision is preventable and treatable if managed in a timely manner.



Symptoms
Diabetic retinopathy progresses slowly without any noticeable symptom and the first symptom may be a severe vision limiting event.



Predisposing factors
-Long duration of disease
-Poor glucose sugar control
-Increased blood pressure
-High serum lipid concentration
-Pregnancy
-Anemia
-Kidney disease



Screening for Diabetic Retinopathy
In type 2 diabetes examination of the eye by an eye doctor{ophthalmologist} must be done first at diagnosis and then subsequently once every year. In type1 examination after 12 years of age and it must be done 3-5 years after diagnosis. The retinal examination is done with an opthalmoscope.



Management
The key to successful management is prevention.
Interventions are most useful when they are carried out early in the disease, before severe retinal damage is done. Management involves:



a} good glucose control
b} control of lipids
c} control of blood pressure
d} surgical treatment: laser photocoagulation and vitrectomy are 2 different eye surgeries that can be used to treat it.



Diabetes mellitus can also lead to other chronic complications which a diabetic also needs to be aware of.

What Causes Diabetic Retinopathy

Diabetes is characterized by high blood sugar levels. The hormone insulin is responsible for converting the sugar level or glucose in blood into energy for the body to use as it sees fit. Insulin uses the glucose and hence reduces the blood sugar level. Excessive blood sugar can have serious consequences to the health. Thus diabetes is a disease that interferes with the bodies ability to process sugar by impeding or destroying the ability of insulin to work in the body. A person with diabetes can suffer from many ancillary diseases that are a consequence of diabetes. One such disease is known as diabetic retinopathy. This article will discuss diabetic retinopathy and it's causes.



Diabetic retinopathy, as the name suggests affects the retina and the ability of the eyes to function normally. It is often a consequence of having diabetes over a long period of time. It is usually very hard to detect by the individual until the condition has taken hold so diabetics are always advised to get their eyes checked on a regular basis.



High sugar levels in the blood are thought to damage blood vessels over time. This damage is particularly evident in the extremities of the body like the feet or on thin blood vessels that can be found around the retina of the eye.



Over time micro aneurysms will occur on the retina's blood vessels. These are weaknesses in the walls of the blood vessels that cause the vessel to balloon out in certain areas. These aneurysms are prone to burst because they are thinner and weaker. Blood vessels around the retina also become blocked. As more become blocked the retina becomes starved of blood and more blood vessels grow in response to this. These new blood vessels are thin and weak too.



As diabetic retinopathy becomes more entrenched it enters a phase termed proliferative retinopathy. At this stage the weakened and new blood vessels can leak blood into the vitreous humor or solution that is in the eye. Depending on how severe this leakage is the sufferer can experience vision loss or blindness.



Prevention or management of the disease is better than any treatment. The best way to prevent or at least manage the condition is to keep blood sugar levels at a normal level as much as possible. Commonly this involves eating the correct foods and plenty of exercise. As many diabetics are likely to suffer from diabetic retinopathy it is also a good idea to get eye check ups regularly so that the condition of the blood vessels around the retina can be monitored.



Treatments for diabetic retinopathy involve laser surgery that aims to shrink or seal blood vessels around the retina but this can only stop the condition worsening. If vision loss has already occurred this vision will be lost for good.



Diabetic retinopathy is one of the more common diseases that will affect anybody that has been a diabetic for any length of time. It is, effectively, blood leaking into the eye which causes the eye to malfunction and loss of vision. By living a healthier lifestyle and consistently monitoring the condition of the eyes, diabetic retinopathy can be minimized and treated.