Hi Fraser,
firstly, well done for starting to take control!
I was diagnosed in 87 when I was 8. My stepmother (a nurse) wouldn't know a healthy diet if it fell on her and my dad is totally slack, so as a kid I got into some very bad habits. I knew all the theory about blindness and amputations and all the horrible things that can happen to diabetics but I was always kind of convinced it wouldn't happen to me. My HbA1c was always about 15, but doctors always said 'you need to get better control' without ever explaining how. So my control was pants for years. I got hospitalised for dka once cos nobody ever told me that you still need insulin even if you've got food poisoning and can't keep any food down. Not fun.
Anyway, I had 'early diabetic changes' for about 15 years before it developed into background retinopathy, so there's a good chance you still have time to prevent your changes getting worse, as long as you stay in control.
I used to drink stupid amounts when I was 19, as well as taking a variety of drugs and following an awful diet. It really doesn't help your blood sugars! Now I rarely drink, partly cos I don't actually like being drunk (or talking to drunk people!) and partly cos I don't like wasting my calories on drinks, particularly as most alcohol doesn't taste good. You can get away with it occasionally but you need to check your blood if you're drinking and always carry some kind of hypo treatment.
I'd recommend going on a dafne course if you can. I did it in January and it's the most useful thing I've ever done. I never understood about the number relationships between carbs and insulin and blood sugar level before. I've always counted carbs, I just never knew how to use that information. Every day on the course I learnt stuff that I feel I should have always known. Since January, I've got my HbA1c down to 7.4 which is the lowest it's ever been. All my doctors are over the moon about it, it's so nice to go to appointments without being told off! But since tightening up my control my neuropathy symptoms have gone and the opthalmologist says my eyes are doing really well and I don't need any more laser. Yippee! I hate laser.
So anyway, keep up the good work. If you stick to it, hopefully you can avoid having any laser. It took me over 20 years to start taking my diabetes seriously and I'm very lucky I didn't do myself more damage. I've had a ton of laser on my right eye, which has really affected my peripheral vision, and a bleed has left me with a 'floater' right in the centre of my vision, which drives me mental. It's so distracting and I've had to give up hopes of being a radiographer as my vision is rubbish in that eye. So believe me, it's really worth putting the effort in to looking after yourself.
Good luck with it all
Jo