DIABETIC RETINOPATHY

Hi Everybody

Over the last few months I have at long last got my B’S’s to pretty near normal and have been feeling quite pleased with myself. Yesterday I suddenly ended up with a huge blob in my vision from the right eye. I saw an emergency ophthalmologist who told me it was a pretty hefty bleed. I am booked in at my local eye hospital for them to try and sort it out this afternoon. I looked up at a site about diabetic eye disease (see below) and to quote “ A sudden improvement (lowering to normal) of glucose levels in a person whose diabetes has been poorly controlled for sometime may cause rapid and uncontrollable retinopathy” The eye clinic for years have told me to get good control of my diabetes and no mention was made of this sort of problem. Any one else heard of this? At times you just can’t seem to win.

Regards


John


http://medweb.bham.ac.uk/easdec/retinop ... ession.htm

Hi fergus,

The one thing I won’t ever do is revert to my old high carb diet, which I now realise was killing me, having at long last achieved what I have been trying unsuccessfully to achieve for many years. What I find annoying about all of this is that for years of visiting my diabetic clinic on a regular basis it was never suggested that I reduce my carb intake. When I spoke to a dietician I was told I was doing all the right things, eating good long acting carbs like potatoes, pasta, rice etc. It was always suggested that I increase my insulin, which I of course did and ended up putting in alarming amounts and still not getting good control. It was only when my endocrinologist wanted me to start using a pump that my wife made the very valid point that if the insulin wasn’t doing its job now was the pump going to rectify this problem and of course the answer is that it wouldn’t, it would just make it more convenient to put in huge amounts of insulin. At that point my wife found my original diabetic cookbook and started me on the diet that I was first advised to follow i.e.150 grams of carbs per day. This started to work immediately. I have now reduced my carbs to around 30g per day and I have been astounded by the results. Regarding the eyes I was aware that some damage had occurred and there was talk of possible laser surgery. Whenever I had a letter from the eye hospital it always mentioned that it was imperative to keep a tight control. When at long last I achevied near normal B’S’s I naively thought that my eyes would improve. It would appear that there is a case for reducing B’S’ gradually. It really would have been nice if I had been made aware of this. However I am now booked in to have some extensive laser treatment on both eyes, which I am not entirely happy about, as it is not without some risk. However I am told that without it I will go blind. Once upon a time I believed everything I was told by the medics but now I am just a little sceptical. Yes I will probably go blind without treatment but I wonder in how many years this will be? If the laser treatment went wrong it could be sooner rather than later. Other than that life is fine. Regarding blood pressure mine always tends to be on the low side.

Regards

John

Hi Fergus

Thanks your last post was encouraging. The eye surgeon I saw seemed to suggest that unless I agreed to extensive laser treatment, I would go blind. (I did make him aware that my B’S’ over the last few months have now improved and are now very near to normal.) I am not entirely convinced of this prognosis and firmly believe that with my improved B, S,s this condition should also improve. He then explained the risks and said that in some cases it can go wrong in which case I would have to notify DVLA and my driving career would be over, not a very pleasant thought as I rely on my car to go out and about. I am of course concerned that I might get another bleed that would seriously impair my vision. The bleed that I had on Monday which really did impair my vision, has of its own accord dramatically reduced in size and I am now hardly aware its there. However I am now booked in to have some laser treatment next Wednesday which he described as “gentle” he wants to follow this up at a later date with more aggressive laser treatments (these are the ones that carry the risks) When I see him next week I will find out a bit more and make a decision as to the best course to take. It seems he is saying if I don’t have the treatment I will eventually go blind and if I do have the treatment and it goes wrong this could happen sooner rather than later or I could be left with seriously impaired vision.

Thanks Sugar pie your post was also encouraging, a pretty nasty thing to happen at your young and tender age. I am really pleased that it worked out for you. I am somewhat older than you and have until relatively recently had very poorly controlled diabetes. As a matter of interest how well is your diabetes controlled at the moment?

Regards

John

fergus said:

Hi John,

I dug out an old piece of research which hopefully will give you some encouragement.

The National Institute of Diabetes and Digestive and Kidney Diseases in the USA produced a 10 year study in the mid '90's looking at the effects of 'improved' blood sugar control on reducing things such as retinopathy. The blood sugar levels reported were good, but still not as 'normal' as the levels many of us low-carbers are achieving regularly. Still, they found a 75% reduction in the progression of retinopathy, 50% reduction in the risk of kidney disease, 60% for nerve damage, and 35% for cardiovascular disease. If blood sugars are fully normalised, the implication was that these figures would approach 100%.

So, whatever damage has been done in the past, I think your current diet will give you the very best shot at a full recovery.

I hope it goes well for you.

All the best,

fergus

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Hi fergus
That is encouraging. The website I quoted in my first post on this subject states
“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. A lot of laser may be needed, and usually stabilises the condition.
A typical scenario: a patient has poorly controlled diabetes (HbA1c 9%) for many years, and gradually develops retinopathy. She may have mild retinopathy, is told how important it is to control her retinopathy, and then becomes very frightened, starts to control the diabetes very well, and the retinopathy starts to get rapidly worse. She develops macular oedema that becomes diffuse and will not respond to laser. Gradually the retinopathy becomes under control but there will have been permanent macular damage and her sight is markedly reduced”
I can’t think why when the eye clinic was telling me to tighten my control that I was not made aware of this possibilty.

The thought of all this laser surgery has put me in somewhat of a dilemma as I would like to think that now that I have just about “normalised” my B,S’s things will improve without too much intervention, although this does not seem to be the view held by the eye surgeon that is treating me. I however have learnt from past experience that they are not always right but of course they do have the ability to frighten the living day lights out of us or I should say out of me.

Regards

John

sugarless sue said:

Just a thought ,John,are you taking aspirin by any chance? I have seen several people take ocular bleeds because of aspirin.Again ,if you are,talk to your doctor about it before embarking on any course of action.

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Hi Sue
Didn't mean to ignore your post. I am not taking asprin on a regular basis. I do occasionaly take it for headaches. However I will now refrain from using the stuff.

Regards

John