Worried About Complications - Specifically Eyes

[MarkC380]

To preface, I have been a type 1 diabetic for over 15 years. My last A1C was 6.1 (which by all accounts is great!), however I am told that despite this I am still at a pretty good risk for complications due to the duration I have had the disease for.

The thought of diabetic retinopathy scares the hell out of me. I know I'll probably have some visual disturbances later on, but I'm only 27... Is it possible to maintain clear 20/20 vision even with background retinopathy with good control?

 

[AndBreathe]

To preface, I have been a type 1 diabetic for over 15 years. My last A1C was 6.1 (which by all accounts is great!), however I am told that despite this I am still at a pretty good risk for complications due to the duration I have had the disease for.

The thought of diabetic retinopathy scares the hell out of me. I know I'll probably have some visual disturbances later on, but I'm only 27... Is it possible to maintain clear 20/20 vision even with background retinopathy with good control?

Hi there, Mark. I’m not T1, so have no personal wisdom to share, but my understanding is that “good control” helps you to stay healthy, in all sorts of ways, including eye healthy, however, that assumes that your A1c of 6.1% isn’t made up of many, many hypers and hypos smoothing out the averages.

Of course, as someone dependent of exogenous insulin, you will have some readings higher and lower than ideal, but it’s about trying to stay in the middle ground.

Im sure other will add their 2p worth when they log on.

 

[EllieM]

Hi @MarkC380 and welcome to the forums. I don't know about 20/20 vision, because even non diabetics develop eye issues as they get older. (My non diabetic husband has needed reading glasses since his mid 50s.) and loads of non diabetics get cataracts or other eye conditions. (My biggest issue with my eyes is caused by a condition that is completely unrelated to diabetes.)

But very few diabetics now lose their sight. The regular eye checks mean that most problems get dealt with in time to preserve sight.

Personally I've had T1 for almost 54 years and have had one cataract done (probably earlier than if I was non diabetic) and have a bit of on again off again diabetic background retinopathy, still not requiring treatment.

In my opinion (disclaimer am not a doctor) your outlook looks very good, though of course there is always an element of luck in health issues. But keeping good control minimises the need for good luck.

And interestingly

Diabetic Retinopathy and Systemic Factors

Diabetic retinopathy, an oculardisease, is governed by systemic as well as local ocular factors. These include primarily chronic levels of blood glucose. Individuals with chronically elevated blood glucose levels have substantially more, and more severe, ...

www.ncbi.nlm.nih.gov

The relationship of blood glucose to retinopathy is continuous, with no threshold although individuals with hemoglobin A1c levels (a measure of chronic glycemia) <6.5%, generally develop little or no retinopathy

Congratulations on your excellent control.

 

[MarkC380]

I do have some swings, however I recently got a Tandem pump with Control IQ so it's helping! According to my CGM, my blood sugar levels are between 4.5-8.0 70% of the time, but I do have more hypers than I'd like

 

[jaywak]

I've been type 1 for 49 years and have mentioned on the forum several times that for probably 25 years I never thought to look after myself but here I am nearly 65 with no eye issues whatsoever so don't assume you will be having problems and with the technology today you are starting in a much better position .

 

[AndBreathe]

I do have some swings, however I recently got a Tandem pump with Control IQ so it's helping! According to my CGM, my blood sugar levels are between 4.5-8.0 70% of the time, but I do have more hypers than I'd like

When it comes down to it, we can only do our best. Life doesn’t allow us to be perfect the whole time, so our best on any given day, whilst juggling everything else has to be good enough.

And never forget, no everything that happens in life, including eye, kidney or nerve issues relates to diabetes.

 

[Mark the Spark]

To preface, I have been a type 1 diabetic for over 15 years. My last A1C was 6.1 (which by all accounts is great!), however I am told that despite this I am still at a pretty good risk for complications due to the duration I have had the disease for.

The thought of diabetic retinopathy scares the hell out of me. I know I'll probably have some visual disturbances later on, but I'm only 27... Is it possible to maintain clear 20/20 vision even with background retinopathy with good control?

Hi Mark,
Without patronising, don't worry.
I have been T1 46 years and have retinopathy. I have had laser treatment to both eyes appx 14 years ago and currently I am being monitored every 4 months at a specialist NHS eye clinic.
My general eyesight is very good, I have no issues working as an Electrician and satisfy all requirements for driving.
I have genuinely been very well controlled in my adult years ( little iffy in teenage years).
I firmly believe it's luck...I know that throws all the medical advice out of the window .
In comparison I know another T1 who's has been T1 a similar time to me and he hasn't looked after himself very well at all, he has had no eye issues whatsoever....I know , it's not fair!!
All the best
Mark

 

[Prancy]

I’ll just add to what others have stated. My former ophthalmologist told me that if you’re going to have eye complications as type 1, it normally occurs within 15 years. I don’t know if that is true. I’m T1 for 24 years and so far no diabetes complications. (I have had reasonably good control, though periodically I ran high (8-9 a1c) and even had DKA once.)I do see a retina specialist every 9 months and cornea specialist annually for non diabetes eye issues, including dry eye.

Vision issues really concern me, but I try to not focus on it. Anxiety can cause all kinds of issues. I recently had my retina checkup and my vision had improved dramatically and the condition of my eyes was much better. She was amazed at how good they were. So now, I’ll return in 9 months. I believe it was due to my recent healthy diet, exercise, vitamins, a1c reduction, reducing stress, etc. I have no other explanation. If not for my astigmatism, I’d have 20/20.

Good luck with everything. I’d find a good ophthalmologist and get regular comprehensive exams. I have done that every year since my diagnosis.

 

[In Response]

When I was diagnosed with Type 1, I was told to expect complications (retinopathy, neuropathy, etc.) within 8 to 10 years.
That was 20 years ago. I saw some background retinopathy about 6 or 7 years ago but have had clear results every year ever since.
I have no neuropathy. My liver, kidneys and heart are all healthier than the average person if my age.
Yes, there is greater risk with Type 1 but by maintaining good management of our diabetes (whilst balancing that with the rest of our lives without letting diabetes take over) can significantly reduce that risk.
I would never say I will never get complications but I will do all I can to reduce the chance.
Like you, I fear eye problems but the worst I have experienced in my life is a scratched cornea which has absolutely nothing to do with diabetes.

 

[Fern Hopper]

Type 1 for 57 years. HbA1c of 37. Weight of 53 kg. BMI 22. At 66 I am probably fitter than most. No neuropathy. No retinopathy. Even a recent cancer diagnosis and treatment hasn't been much of a difficulty. Back running Parkrun within 3 weeks of cancer surgery. Tight control helps I think.