Diabetes Related Eyes

Hi Siobhan,
This link to the NHS information site will tell you everything you could possibly want to know about diabetic retinopathy (and a few things you probably didn't want to know!).
http://www.nhsdirect.nhs.uk/articles/ar ... icleId=129

Retinopathy is not uncommon and several of our regular contributors have suffered from it. One thing to remember is that when caught in the early stages, retinopathy can generally be reversed by lowering your blood sugar levels, and that is likely to mean reducing the carbohydrates in your diet.

Have a look round the food and diet threads on the forum and you should start to get an understanding of what you will need to do to lower those blood sugars. But just ask if you have any questions.

This thread will provide further info. I took notes, & will be putting in a report on the thread.

Summarising, screening has shown a serious incidence of retinopathy, and "they" are recommending better control of BS levels, below 6 rather than 7. Retinopathy is reversible in its early stages (me) by better BS control. I've already reduced my overnight readings from 6.7 av to 5.3 following reduced card recommendations on this site.

Yet another link. Sorry its a bit scary but it is potentially important. It also tells you how to reduce the risk, (and that overall its still better in the long run to reduce BS levels)

A sudden improvement (lowering to normal) of glucose levels in a person whose diabetes has been poorly controlled for sometime may cause rapid and often uncontrollable retinopathy. This is a very common problem in clinical practice. Good diabetic control is essential in the long term, but unfortunately in the short term may cause a rapid deterioration in retinopathy

Click to expand...

http://medweb.bham.ac.uk/easdec/retinopathyprogression.htm

NB its not just this hospital saying this. I was aware of it because the French 'rules' for getting a pump insist that everyone before a pump start have an angiograph of their eyes. If existing BS coupled with eye examination shows risk they plan a controlled, well monitored reduction in average BS levels, plus extra strict BP control, rather than the rapid reduction that the pump could perhaps allow.

Siobhan said:

He never mentioned the word, Retinopathy, basically on the photo there was like little tiny yellow dots in a small section, i'm going round in circles trying to find stuff on the internet. All he called it was slight leakage, which he said if i lost weight and got a tighter control of my diabetes it might clear up, has anyone else experienced this?

Click to expand...

Siobhan,

The talk on Wednesday was by Shahjalal Ahmed of the screening service. He stressed the phone number for queries 020 8998 5541. I think you would be able to phone, even if you are not in the West London area. email eh.drss@nhs.net

My report for the left eye was: background retinopathy & non-referrable maculopathy. The report did not advise better control to reverse the condition, nor was it a point of discussion. I assumed it was all part of diabetes being a progressive disease.

Shahj showed photos & explained:
[I hope I've got it right]
The eye is a window into the body for nerve damage - what they see in the eye is occurring elsewhere - if you've got retinopathy there will be other nerve damage;
in the early stages, these changes are non-symptomatic;
white spots are where the retina capillary blood vessels are shutting down;
this is reversible in the early stages by improving b/s control;
[he did not say if it would stabilise in the later stages by improved control];
when the capilliaries shut down, new ones form which are weaker & prone to bleed, (showing as red spots) causing cloudy vision & ultimately loss of vision;
laser treatment stops the progressing (it doesn't repair) by destroying the point at which the new b/vessels form. Vision is likely to be stabilised, but will still be impaired.

The lady from DUK said they had reduced the target values for bs control because of the incidence of retinopathy at the previous levels. Now 4-6 before meals, 8 after, instead of under 8 & below 12 after.

Hope that helps.

Ian

No, we're not, thats not what the links say. Once when early detection and treatments weren't available maybe but not now. There are many people who have had retinopathy and either reversed the problem through better control/reduced BS or have been treated and have stablised the problem. It may be that there is little to worry about, I have a few 'diabetic changes' brought on possibly from changing from being undiagnosed and uncontrolled to very tight control, who knows?. Although they're there, I only have to see the opthamologist once a year.

I wish I hadn't worded my answer as I did, but I didn't want you jumping in with 2 feet, running after the low carb faction and attempting to get normal BS overnight. That wouldn't necessarily be a good thing :wink:

Try and get that appointment as soon as possible, it will give you less time to worry.

Must admit, this thread more than slightly piqued my interest, as in addition to being diagnosed with type 2 about 18 months ago, I am also blind in my right eye thanks to a stroke some 13 years back. I've now been told that I have advanced deterioration in the field of vision in my left eye, and yet, in the same breath, I've been told I don't qualify as partially sighted. I've been told privately that my tests indicated a total loss of 65/70% of vision overall, and yet the consultant @ hospital still insists that (in his words) legally he can't qualify me as partially sighted.

What the heck do they need--total blindness, and then they might see their way to letting you qualify for a white stick? And then they wonder why I don't go anywhere near this so-called "medical team". They're about as much use as flatulence in zero gravity............

Scots

Siobhan said:

pretty grim really, we're all gonna go blind.

Click to expand...

Siobhan, the point of the screening is to prevent blindness. What did they say when you phoned 020 8998 5541 ?

I've just phoned & mentioned you - They are there 9-5 Mon to Fri. You've got 20 minutes today.

He was very helpful, looked up my results & explained.

I have mild retinopathy, which has been stable on every visit to the diabetic eye clinic. they agree it probably happened before I was diagnosed and that tight BS control is keeping it in check.
However. I do go to an ordinary optician(Boots) for glasses and when last I went, the optometrist insisted that I needed to go to the hospital and wrote a letter to my GP. I told them I knew about the retinopathy and that so did the hospital. Anyway. I had a Ggp appointment and asked if they'd heard about the matter. NOTHING, next time I saw GP weeks later, he said he'd had notification that I'd missed a hospital appointment. I told him I'd have gone if I'd been informed. I had a routine eye clinic appointment about a month later. I got to the reception desk and handed over my card to be told "This appointment has been cancelled, because you had an emergency one". "They could have told me" I replied. Anyway the eye clinic, very kindly, put me in on the end of the session.
Every time i have an eye appointment,something happens. It gets changed. my latest one has been moved from September to November. Is it any wonder I'm wearing glasses with an out-of-date prescription?
I've worn them all my life It's not diabetes relateed.

Siobhan said:

Mentioned me? What did you say exactly...

Click to expand...

"You had little tiny yellow dots in a small section & were worrying yourself on the Internet, & that I had given you the number & recommended you phone, even though you were probably out of his area."

I can't say anything you haven't already told the world of cyberspace.

Just being helpful ....

Ian

I think we all hate diabetes like all chronically illl people hate their illnesses. But there are still choices in how we deal with things. It is true, as it's worst we can lose our legs, eyes, kidneys, fingers and ultimately our lives. But so can any healthy person walking down the street. Much depends on how you deal or don't deal with your diabetes... I work in operating theatres and have seen it all and it really has hammered things into my head. Not one of the patients I have encountered has had good and tight control of their condition! Blood sugars have averaged roughly between 11-18....

Heavy drinking (beer/ cider), smoking, not taking medication and uncontrollable high bolood sugars have featured with these people, the "I don't care" mentality and losing interest in their own wellbeing also. I have seen diabetics outside the hospital doors smoking for hours after their surgeries complaining the hardship of their life eating cupcakes and drinking strong cider. All diabetics around me are healthy and controlling their illness with superb efficiency and tackling problems with speed. That is what we have to do if we want to maintain our healths as far as possible. I am worried of all the possible complications but am still determined to fight as long as I possibly can and not even stop there. I think having many other illnesses would be so much worse, at least we can have a long normal life if we take care of ourselves where as many other people can't.

About 18 months ago, i was sent by my diabetes clinic to the optician and told to ask for a full retinal screening test.

This i did and the results were 'normal although i can tell you have diabetes'. At the time i was feeling as though every week i had a battery of tests to endure and didnt query the results.

In November last year, i was summonsed by the NHS to a new eye clinic and had the very same test as i'd had in the optician the previous year.

This time, i was told i had a small 'mark' which was early stage retinopathy. I panicked and was assured that it was tiny, perfectly normal within diabetic patients and not to stress.

I did stress, though and so their consultant phoned me later that day to say he could see a little leak on the nasal view of the lower portion of the right eye. He said it was hard to spot but they were trained to find such instances and were using state of the art equipment.

My HbA1c results have always been good - since diagnosis, 5.6; 5.4; 5;4 and 5.4 and i eat a lowish-carb diet and take Metformin 850mg once a day, with no ill-effects since the first three weeks passed.

The consultant who phoned me said he was confident there wasnt a real problem, providing i maintained good BG levels and assured me that very often, such tiny leaks appeared then were absorbed back into the body and had no lasting ill-effects. He cautioned, though, that they were looking for areas with more than one such leak, areas with larger leaks or leaks that didnt get reabsorbed. Meanwhile, i was fine and need come back only when summonsed, in a year.

I might say that i wasnt mollified at all and fell into a sort of depression, hating my diabetes and feeling a failure. My BG levels are pretty stable and i dont go mad although now and then i allow myself a treat. Not regularly, though.

Today i feel less panicked by the eye test results and more resigned. It's just one more issue and serves, to me anyway, as a reminder of what might get worse if i stopped taking care of myself.

But i still hate diabetes.

bunty

I know, having diabetes sucks but what I was saying, it doesn't have to be the end of the world. I know for certain that I am much to blame for my condition but if I was to dwell, I'd probably throw in the towel right now and resign to my own dark world of self pity and self destruction. But then the diabetes demon would have won and I can't have that, and hopefully will have the strength to fight all the way. I have been reading dr Bernstein's story and it is very inspirational reading. But he has proven that certain complications can be reversed but of course it is really hard work. I find I'm able to maintain low(er) carb diet much easier than low gi or low fat and about one month after diagnosis now my sugars stay under 6 most of the time so if I was to be tested now, I would be told I didn't have diabetes...

Hang in there, there will be light at the end of the tunnel!