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Diabetic Eye Disease

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Diabetes: Don't Let It Kill You

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editors: Melissa Conrad Stöppler, MD

Diabetic eye disease is a complication of diabetes Diabetes is pretty easy to understand. The body needs glucose (or sugar) as a power source for metabolism. Insulin, a molecule made in the pancreas, acts as a key to open cell doors and allow glucose to enter cells from the bloodstream and allow the necessary power generation to happen. In healthy people, the pancreas can help regulate blood sugar levels and make certain that cells get the energy source they need. In people with diabetes, the system doesn't work; either the pancreas doesn't make any insulin, doesn't make enough insulin, or makes insulin that isn't effective. This causes blood sugar levels to rise, cells to malfunction, and the body to break down.

The treatment of diabetes is theoretically easy. Balance the glucose intake in the diet with the amount of energy the body needs to do its chores, and then add medications by mouth or insulin injections to make it all happen. Reality isn't that easy, and for many people, poorly controlled diabetes leads to problems years later. Small blood vessels start to become narrow and fragile. Organs lose blood supply and begin to fail, slowly at first, but then life-threatening events can occur. Heart attacks, kidney failure, poor circulation in the feet (sometimes requiring amputation), and blindness are just some of the effects of blood sugar levels that remain chronically too high.

Diabetic Eye Disease Overview

Diabetes mellitus is one of the leading causes of irreversible blindness worldwide, and, in the United States, it is the most common cause of blindness in people younger than 65 years of age.

In addition to being a leading cause of blindness, diabetic eye disease encompasses a wide range of problems that can affect the eyes.

Diabetes mellitus may cause a reversible, temporary blurring of the vision, or it can cause a severe, permanent loss of vision.
Diabetes mellitus increases the risk of developing cataracts and glaucoma.

Some people may not even realize they have had diabetes mellitus for several years until they begin to experience problems with their eyes or vision. Severe diabetic eye disease most commonly develops in people who have had diabetes mellitus for many years and who have had little or poor control of their blood sugars over that period of time.

Diabetes mellitus may also result in heart disease, stroke, kidney failure, and circulatory abnormalities of the legs.

The American Diabetes Association estimates that 20 million people in the United States have diabetes. One-third of this population is unaware of their illness. A recent change in the exact definitions of diabetes and "pre-diabetes" by an international expert committee leads to the estimate that an additional 41 million people in the United States (40% of adults aged 40-74 years) have "pre-diabetes," a condition that significantly increases their risk for developing diabetes.

This new definition underscores the importance for everyone to take steps to help prevent the development of this disease. Individuals can try to avoid the problems associated with diabetes mellitus, including those that affect the eyes, by taking appropriate care of themselves by:

Maintain a normal weight
Watch your diet, especially limiting unhealthy types of fats and substituting complex carbohydrates for simple carbohydrates.
Participate in an exercise program, performing at least 2 1/2 hours of aerobic exercise very week.
Do not smoke

Lifestyle management has been shown to reduce the risk of developing type II diabetes and pre-diabetes by at least two-thirds. It can also slow or halt the progression of pre-diabetes to diabetes.

If you or someone you know has already been diagnosed with diabetes mellitus, the following steps should also be taken:

Monitor blood sugars and glycosylated hemoglobin. (The protein in the red blood cells that carry oxygen is called hemoglobin. Glycosylated hemoglobin is hemoglobin that has bonded to blood sugar.)
Take diabetes medications as prescribed by the healthcare provider.