A long-time patient made a comment that it seemed to her that “everyone” has either prediabetes or diabetes. She was not too far off. According to Centers for Disease Control and Prevention (CDC), 30.3 million Americans or 9.4% of the US population have diabetes; 23.1 million people have diagnosed diabetes and 7.2 million people have undiagnosed diabetes. The prediabetes statistic is even more staggering…84.1 million or about 1 out of 3 adults in the United States have prediabetes and 90% of them do not know they have it.
People who have diabetes are at a higher risk for blindness, kidney failure, heart disease, stroke and loss of toes, feet or legs. The risk factors for Type 2 diabetes are overweight, family history, physical inactivity and age (45 and older).
How does diabetes cause vision or eye problems?
Often times blurry vision or vision change is the first sign of diabetes. The high blood sugar causes the lens in the eye to swell and thus changes the vision. Once the blood sugar returns to target range, the vision will return to “normal”. It may take as long as 3 months for the vision to return to normal.
Cataract occurs when the lens in the eye becomes cloudy and causes vision to become cloudy/foggy, dim and blurred. Everyone, at some point in life, will be diagnosed with cataract. People with diabetes tend to be diagnosed with cataracts earlier in age and the vision gets worse faster. Cataract surgery will remove the cloudy lens and replace it with an artificial one.
Glaucoma is typically diagnosed when the pressure of the eye is elevated. This happens when the fluid inflow and fluid outflow of the eye are not balanced where the outflow is not sufficient to handle the inflow, thus creating higher pressure. The higher pressure can cause damage to the optic nerve and vision changes. Glaucoma eye drops are usually used to reduce the eye pressure.
People with diabetes can get a rare form of glaucoma, neovascular glaucoma. Neovascular glaucoma occurs when new blood vessels grow on the iris, the colored part of the eye, and block the normal fluid flow of the eye causing the pressure to increase.
The retina is the “back” of the eye. It is equivalent to the film in a camera. It turns light rays into images that the optic nerve sends to the brain.
Diabetes can affect the retina. High blood sugar level can cause damage to small blood vessels and create weak new blood vessels.
There are three main categories of retinopathy, background, maculopathy and proliferative.
Background retinopathy occurs when the blood vessels are damaged but the vision is OK. Background retinopathy can get worse if diabetes is not controlled.
Maculopathy occurs when the macula, the area of the retina that sees the clearest, is damaged. The vision is greatly affected with maculopathy.
Proliferative retinopathy occurs when not enough oxygen is provided to the retinal cells and new blood vessels start to grow. The new vessels are weak and they can bleed and lead to a clot. Scars can form and cause a retinal detachment.
Does everyone with diabetes have eye problems? The answer is NO! Most diabetes related eye problems can be avoided or be less severe by maintaining optimum blood sugar control. If you have prediabetes, you can prevent or delay Type 2 diabetes by losing weight, eating healthy and being more active.
Diabetes may be a “life” sentence but it does not have to be a “death” sentence. Changes in lifestyle/habits can reduce the risk of prediabetes becoming diabetes by half. Working with all your health care professionals is critical in maintaining a long productive life living with diabetes.