Diabetic eye screening results

[Juicyj]

Ok, this is to get some feedback as I had my first eye screening result after 2 years being diagnosed as a type 1.

The examiner said I had the eyes of a non diabetic, however I got my letter back today to say that I do have some background retinopathy, which has left me a little bit sad.

I've really tried hard since diagnosis to become an 'expert' and now do low carb so as to avoid the highs and lows that cause this, and so to avoid the long term complications.

Is it right that after just 2 years this can happen, my last HbA1c was 5.7 (was chuffed at this too but now thinking it's not good enough..).

Can anyone give me some inspiration !!

 

[mrburden]

The thing with being diagnosed is that few of us know how long things were running a bit high before diagnosis. This seems particularly true for T2's but must be relevant to T1's as well.
With that in mind, it is quite possible that the complications we can suffer as a result of diabetes could be partly caused before any outward signs are found. My own retinopathy only occurred after some 20+ years of diabetes, in my early 30's, but I know people who have been diagnosed only a year before complications set in. My guess is that they may have already had some problems that had not been noticed so they seemed to develop very quickly after diagnosis. But I also know people who have abused themselves by taking no interest at all in what goes into their mouth both before and after being diagnosed, yet seem to suffer little as a consequence.
Your levels seem pretty good to me so it may just be a case of bad luck which, I'm sure, also plays a part in all the complications some of us get or don't get.

 

[Juicyj]

Thanks for taking the time to respond Mr Burden, I hadn't thought about that, think i was type 1 for a few years before actual diagnosis as I had gestational diabetes 3 years previously and been ill on or off before type 1 was realised so potential for damage was there.

I also think it is the luck of the draw - some people have better genes than others. It just made me quite sad to think of how sensible i've been since and how much i've learn't to try and get better at this, so didn't think I could be a contender for retinopathy.

I read the Berstein book on type 1 too - so do you think there's any chance you can reverse the effects or once the damage is done that's it ?

 

[Auckland Canary]

I have had mild retinopathy for nearly 10 years and it is obviously a worry. However I have been informed that almost every diabetic will get it eventually after a period of time. I have been Type 1 for 30 years so I think yours may be relatively early.

What is interesting though is that as long as your control is good and the damage is not bad it can repair itself. I have seen numerous photos of my eyes over the years and you can see patches where it gets better and will then deteriorate in others.

Also as long as the damage does not get too bad you can have an operation to clean up the ends of the blood vessels using lasers that stop them bleeding and essentially cauterise the wound.

The best thing is to keep your levels under control and it is vitally important to attend your eye screening every year to ensure the damage is kept in check.

 

[mrburden]

I have heard of cases where retinopathy has 'reversed' but I suspect, as mentioned above, these pepole are very lightly affected and detected ay an early stage. The laser treatment prevents the active vessels from bleeding further, but in itself it is a destructive treatment because it creates burns on the retina which then remain permanently blind. Consequently, the more laser shots you receive, the more sight is permanently lost. Only surgery such as retinal transplant could ever replace the lost vision.
But who knows what will become available with the progression of stem-cell treatment?

Sent from the Diabetes Forum App

 

[noblehead]

Juicy, not wanting to get your hopes up falsely but I was reading something last year that said 40-50% of people who have background retinopathy don't progress to the proliferative stage, the good thing is now it has been picked-up they will monitor your eyes closely and identify any changes.

It's sad after only 2 years you have these changes in your eyes but try not to worry too much about it, the advice I was given when my retinopathy was active was to keep bg, bp and cholesterol levels all under control and eat a diet rich in fruit & vegetables (the darker the better), if your bp is borderline you might want to discuss with your gp about lowering it.

 

[agulajszon]

Hi,
If you think your diabetes is well controlled you shouldn't worry. I have a diabetes Type 1 since 30 years and I have rethinopathy after long term bad sugar control. Now, after a years!! my diabetes is much better managed since I joined to Dafne programme. They show you how you can change your lifestyle and live with this condition without any limits. Speak to your GP, he could give you a referral to Dafne course, which is really life changing! You wrote, that you try to became an "expert". It isn't possible, because diabetes could be very unpredictable, even for me (30 years of fight ). I thought that I am some expert, after all my experiences but Dafne team showed me completely new way and I feel better and free. Best Regards
Agnes

 

[kkkk]

Don't shoot me…just repeating a doctor, and I don't know how true this is but they said that background retinopathy can go, and that there might not be any in your next photo if you keep sugars well controlled etc. - was that a false hope or is there truth in it? I know it is a warning sign of some of the damage that has been done, and I know that even with proliferated people have improvements and can go back to background retinopathy…so can background disappear - I guess at the end of the day it is just a few little burst vessels rather than lots, and with better control hopefully no more will burst? Plus 5.7 is a great HBA1c and I would have hoped that would help keep anything at bay with numbers like that.

 

[mrburden]

Don't shoot me…just repeating a doctor, and I don't know how true this is but they said that background retinopathy can go, and that there might not be any in your next photo if you keep sugars well controlled etc. - was that a false hope or is there truth in it? I know it is a warning sign of some of the damage that has been done, and I know that even with proliferated people have improvements and can go back to background retinopathy…so can background disappear - I guess at the end of the day it is just a few little burst vessels rather than lots, and with better control hopefully no more will burst? Plus 5.7 is a great HBA1c and I would have hoped that would help keep anything at bay with numbers like that.

I think that often the overall state of the blood vessels of the retina can be controlled and the leaks can heal, leaving no worse damage than if you suffer a small cut on a finger for example. However, once laser treatment is needed to seal the vessels or to stop new, immature vessels from growing, the situation changes. The laser burns tiny areas of the retina with every shot and each shot leaves a scar. These scars are not repairable and are permanent.
So, the problems with irreversible retina damage are not so much due to the vessels, but more to do with the distructive nature of the treatment