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Retinopathy!!

J

jonnoras

Well-Known Member
Messages
96
Type of diabetes
Type 2
Hi. I haven’t posted in quite awhile as everything seems to have been ticking over quite well. My BG levels have been well controlled by diet (last HbAc1 was 5.1) and I have been happy with the result. However, I had a recent eye screening appointment and got the results back yesterday. The result says I have had some changes in my eyes and have non proliferative retinopathy which doesn’t require treatment. I’m worried because my three previous years results have shown nothing yet despite controlling my BG my eyes are changing. My total cholesterol level is quite high at 6.42 but my other numbers put my Cholesterol/HDL ratio at 3.42 which I’m told is good. My last blood pressure result was 120/79 which I’m told is good. I can’t understand why my eyes are showing signs of retinopathy.
The reason I’m posting is to see whether other people have had similar experiences and to try and get reassurance that it’s not a slippery downward slope to vision loss. Can anyone help? Jon
 
Well, I've had on again off again background retinopathy for years (decades?) with no need for treatment and no (as far as I know) loss of vision. Also, I may be misremembering, but I believe that the automated tests can be inaccurate???

Though I agree that it seems strange you've had any changes at all with an hba1c of 5.1.....

There's a reason that diabetics have regular eye tests : it's so that any changes can be monitored and treated before you lose your vision. The medical profession has got very very good at treating diabetic retinopathy, so try not to worry. I also think that if you maintain that excellent hba1c you have an excellent chance of being told that the retinopathy has gone at your next scan.

Good luck, and try not to stress.
 
Thanks for the reply Ellie. I was wondering whether the retinopathy is as a result of cholesterol rather than glucose. My GP surgery isn’t that up on this sort of stuff (I had to “educate” the practice nurse and GP as to how I reduced my BG). The GP keeps recommending statins but I’m worried about the fact that they increase BG. I’m at a loss at what to do really. Jon
 
If your cholesterol figures are good, then IMO keep refusing statins
 
Thanks Mike. Are there other reasons why I should avoid statins? Jon
 
Retinopathy can arise due to previous periods of high blood glucose - a phenomenon called metabolic memory. https://academic.oup.com/jcem/article/94/2/410/2597928
By controlling your HbA1c and blood pressure you reduce the risk of progression to sight-threatening diabetic retinopathy. Some people find that their background retinopathy disappears after a few years of good diabetic control. There is some evidence that dyslipidaemia can affect maculopathy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133445/

Most people with diabetes develop background retinopathy at some stage and most people do not lose vision. At this stage you only need to worry enough to keep working at maintaining good diabetic control and attending all your eye appointments. (If treatment is ever required, it is most successful when given in the early stages of sight-threatening retinopathy so regular screening is important.)
 
Thanks for all the info dark horse. I wish my GP and nurses were as informed as you and others on this forum. Thanks again. Jon
 
Thanks for the reply DarkHorse. Sorry for the delay in replying, it took a while to get my head round the great articles you posted. Assuming the metabolic memory theory is correct then the damage to my eyes has already been done and they won’t necessarily respond to good BG control anyway will they?(That is a question not a rhetorical question)
Before I was diagnosed with T2 my Total Cholesterol was 4.1 after I’d been on the LCHF and 16:8 fasting diet my HbA1c went down to 5.1 (from 7.8) which was great news but my TC went up to 6.42!! (Although I was told my numbers were good - TC/HDL ratio was 3.4) It feels like retinopathy or maculopathy is going to occur either as a result of too high BG or too high TC. Which then begs the question do I start taking statins now? I don’t take any medication at the moment. I know a lot of people are very anti - statin and I’m as confused as hell as up to this point I’ve refused to take them because my Q3 risk is 10.8% which is just past the cutoff point where GP’s are required to suggest statins and because they are known to raise BG levels!!! Because of this it didn’t seem worth it to take them but now my eyes are showing signs of retinopathy (either BG or TC related) I’m not sure whether I should start taking them. Seems like a viscous circle. Any more thoughts? Thank you for your interest in this. Jon.
 
As I said, some people do report reversing their 'background retinopathy' status with continued good control. Plus, it gives you the best chance of the retinopathy not progressing. I don't think there is currently clear-cut evidence of the effect of statins on retinopathy so probably not a reason for reviewing your decision.

Another article you may find interesting:- http://diabeticretinopathy.org.uk/prevention/hba1c_and_retinopathy.htm
 
Thanks again DarkHorse. Some very interesting reading. I’ve decided to dip into my savings and find a diabetic Consultant with whom I can discuss this further. My GP practice are supposed to contact me annually for a diabetic review/ blood test / foot pricking etc but they never do. I end up chasing them each year. So I’ve decided to seek private help to start off with and see what happens. Jon
 
It's a pain to have to pay for private but at the age of 22 my results changed slightly and GP didnt go quick enough for my liking so I paid for a second opinion... since then I've had slight vision loss and monthly laser and 2 courses of injections and vitrectomy surgery in one eye. Its alot but it was all pushed through privately whereas I know I'd still be sitting on a NHS list somewhere with far worse vision and no treatment! my BG control used to be bad as a teen so I've only myself to blame but drs have said a complication like this can affect you even if you're a textbook perfect diabetic. Not trying to scare or anything but I think it is just part of being diabetic that eventually some stuff comes and bites us! Main thing is, dont worry! Its scarier to think about what it could all mean and how could this happen to you and what happens next but just take it in your stride I know this probably hasn't been much help but just know that you'll be ok no matter what happens.
 
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