Is diabetes affecting your eyes?

Is diabetes affecting your eyes?

Introduction

People with diabetes may experience a variety of eye issues, collectively called “diabetic eyes.” These include glaucoma, cataracts, diabetic retinopathy, and diabetic macular edema. 

 

Diabetes is essentially a metabolic disorder. The body is not processing the food that you eat correctly. A hormone called insulin delivers glucose to the cells in your body. In diabetes, either the body does not produce enough insulin or the cells are just resistant to it. 

 

The blood vessels and neurons, including the ones in your eyes, get damaged when there is too much glucose in the blood rather than inside the cells. This eventually causes poor vision or even blindness. However, by managing diabetes, you can take measures to stop this progression.

How do you know if diabetes is affecting your eyes?

 

  1. Brief episodes of blurred vision:

High glucose levels in the blood alter the fluid quantity inside the eye, leading to swelling and causing blurred vision. This kind of hazy vision is transient and goes away as your blood sugar levels return to normal.

  1. Persistently high blood sugar

This can harm the tiny blood vessels behind your eyes. The damaged blood vessels leak to cause swelling. They eventually rupture and cause bleeding into the center of the eye increasing the eye pressure.

 

Diabetic eyes and their types:

 

Diabetic retinopathy

 

The retina is a structure at the back of the eye. It is the light-absorbing center. Diabetic retinopathy is a condition where the retina is harmed by the surrounding damaged blood vessels.

Blood sugar ruins the health of the blood vessels, leading to leakage into the retina in early diabetic retinopathy. 

As the illness progresses, some blocked capillaries stimulate the growth of newer, frail blood vessels. This causes serious vision issues. Diabetic retinopathy is fairly common. Early diagnosis and management of diabetic retinopathy can significantly lower the risk of blindness—by 95%.

 

Diabetic macular edema

 

The macula is that part of the retina that helps in clear vision. Leakage from the capillaries causes macular edema, or swelling. Blindness or partial vision loss may eventually ensue. Macular edema is the aftermath of diabetic retinopathy.

 

Glaucoma

 

Diabetes is a contributing factor to a certain type of glaucoma. Leakage and overgrowth of the blood capillaries near the iris (the colored part of the eye) raise eye pressure to abnormal levels, leading to glaucoma.

 

Swelling of the eye lens

A sudden rise or fall in blood sugar alters the shape of the delicate lens in the eyes. This results in blurry vision. The vision goes back to normal after your blood sugar stabilizes.

 

Cataract:

People with diabetes may develop cataracts at an early age; the progression of the cataract is also rapid when blood sugar levels are high. This causes a cloudy buildup in the lens of the eye, and blurred vision.

 

Can you have diabetes-related eye disorders?

 

The incidence of eye problems caused by diabetes increases in the following scenarios:

 

  • Uncontrolled blood sugar levels
  • Persistent high blood pressure
  • High blood cholesterol levels.
  • Smoking
  • Comorbidities

 

Early-stage diabetes eyes symptoms

 

Initially, diabetes-related eye disorders show no signs. Gradually, you may begin to notice a few things:

 

  • unsteady or blurred vision
  • poor color perception
  • flashing lights
  • dim areas or reduced vision
  • Frequent vision fluctuations, sometimes even daily.
  • spots or strings of darkness (also known as floaters)

 

There are diabetic eye-related medical emergencies that warrant an immediate phone call to your diabetologist. This includes:

  1. A feeling of a sudden cover over the eyes (blurring)
  2. Rapid flashes of light floaters that remain constant for more than a day.

These could be signs of the retina losing its attachment. Call your doctor immediately.

Eye checkups in diabetes:

If you have diabetes, you need to get your eyes checked periodically. 

  1. You will be given an eye drop in the clinic to enlarge the pupil and have better visual access to the retina.
  2. Pictures of the backs of the eyes are taken using a specialized camera.

 

In-built AI apps are available these days that can read the results of the retinal examination to diagnose diabetic eyes. 

 

Diabetes eye treatment:

 

  1. Treat diabetes at its source by implementing the ABCs schedule, which includes quitting smoking and routine monitoring of HbA1c, blood pressure, and cholesterol.
  2. In terms of medical treatment, VEGF-blocking medications are the mainstay. These can stop fluid leaks and inhibit the growth of abnormal blood vessels in the eye.
  3. With a laser beam, also known as photocoagulation, small burns are made inside the eye. This procedure addresses internal swelling and blood vessel leakage. 
  4. Vitrectomy is the surgical way to remove the vitreous humor or the fluid that fills the inside of the eye. The procedure treats problems with severe bleeding to prevent the formation of diabetic retinopathy.
  5. In the case of cataracts, the cloudy lens is removed and an artificial lens is placed.

 

How to prevent eye damage from diabetes

 

Golden rule: Manage the blood sugar levels first!

 

Check your blood sugar after short breaks or use a continuous glucose meter. You might need to check it more frequently if you are anxious or ill. Provide yourself with a target sugar level and work towards it. 85-140 mg/dL before food and less than 185 mg/dL 1-2 hours after meals are good.

 

Apart from that,

 

  • Maintain healthy cholesterol and blood pressure levels (regular monitoring and medications). Reduce salt consumption. Low-salt diets also assist in maintaining the health of your eyes by reducing inflammation in the tiny blood vessels there. Use pink salt or other herbs to flavor.
  • Avoid smoking. Nicotine patches and e-cigarettes come in handy.
  • Exercise walks, or workouts should become routine. Moderate-intensity exercises like brisk walking are mandatory. Use workout gadgets like smart watches and pedometers to gauge your progress. Find enjoyable exercises to motivate yourself like Zumba.
  • Include face yoga and eye exercises. It is a great way of destressing yourself.
  • Plenty of fruits and vegetables should be included in your daily diet. To help prevent retinopathy, consume fresh fruit, vegetables, and fish. Obesity increases your risk of developing diabetic eye conditions. Simple homemade food and zero junk food can do wonders.
  • Protect the eyes from UV rays and too much screen time. Use appropriate eyewear for the same.

 

 Conclusion:

Periodic screening of the abdomen is vital in today’s world. High levels of blood sugar could be warning signs for other underlying disorders, like pancreatic cancer.

Dr. Nikhil Prabhu ( Diabetes Specialist )

Dr Nikhil Prabhu is a consultant Diabetologist from mumbai. he has been practicing for more than 10 years and currently over 7000 patients are under his treatment for diabetes and thyroid disorder from mumbai and navi mumbai area. | you can book his appointment for tele-consultation on 9082523295 | follow us on YouTube for more diabetes & health related tips

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Relationship between Diabetes and Covid 19

Hello friends as we all know what’s covid 19 actually. Well let me explain you that how the deadly corona virus infects and its transmission. Corona virus means crown shaped virus which transmits from human to human through droplets of infection. Droplets shed by a patient through sneezing, coughing and touch can cause infection to the other person. The window period of the virus is 14 days where the symptoms can appear.

Covid 19 completely compromises the immunity of the person. It hampers the normal living. Some patients are carriers and completely asymptomatic, which can prove dangerous. These patients are usually not aware of them being carriers and they transmit the disease. In India, though the recovery rate is high nearly 70 % still many being carriers of the infection.

When a person suffering from an uncontrolled diabetes suffers from covid his immunity is compromised a lot. Along with symptoms of Covid like sneezing, coughing, fever, bodyache, loss of taste etc it can worsen the Diabetes and it’s complications. Diabetes and Covid 19 is a deadly combination. A person suffering from pre existing diabetes, blood pressure and cardiovascular diseases are at high risk of getting infected by corona virus. Older people suffering from Diabetes are more prone to get infected.

Diabetes &covid19 relationship

Image credits: Sciencedirect.com

Pathogenesis of Covid19 in Diabetes:

Severe acute respiratory distress syndrome (ARDS) SARS-CoV 2 infection itself represents worsening factor for people with diabetes,  precipitate acute metabolic complications through direct negative effects on pancreatic β-cell function. These effects on pancreatic β-cell function can also lead to diabetic ketoacidosis in patients with diabetes. Hyperglycaemia or raised sugar levels at hospital admission in individuals with unknown history of diabetes and potentially pre diabetic state is very common presentation.

Diabetic patients have impaired immune-response to infection in relation to both cytokine profile and to changes in immune-responses including T-cell and macrophage activation. Poor glycaemic control hampers several aspects of the immune response to viral infection and also to the potential bacterial secondary infection in the lungs.

Epidemiology:

Initial studies has revealed a J-curve relationship between HbA1c and risk of individuals being admitted to hospital for infections in general, and infections of the respiratory tract in particular. A prospective cohort study of patients with COVID-19 from New York City,  USA, revealed that the prevalence of diabetes and obesity was higher in individuals admitted to hospital than those not admitted to hospital. In around 7 meta analysis study, showed that around 67% of people in India suffering with Diabetes are at higher risk with Covid 19.

Signs and symptoms of Covid19 in diabetes:

  • Fever
  • Cough persistent
  • Pneumonia ground glass opacity
  • Pressure on chest
  • Loss of taste
  • Muscle pain
  • Difficulty in breathing
  • Increased frequency of urination due to Diabetes
  • Itching all over the body due to uncontrolled Diabetes

Management of Diabetes and Covid 19:

  • One should regularly monitor blood sugar levels.
  • Avoid unnecessary travel
  • Take necessary precautions like wearing mask and gloves, socks to avoid contact with virus.
  • Take your Diabetes medicine regularly.
  • Keep yourself well hydrated.
  • Take multivitamins like vitamin C and zinc on daily basis and weekly Vitamin D if advised by your doctor.
  • If diabetes is uncontrolled, then visit to your diabetologist at the earliest. Take insulin injections as prescribed by your doctor.
  • If a person suffering from Diabetes is exposed to virus, take your anti biotics and prescribed medication regularly along with anti-diabetic medication.

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Awareness is Prevention.

 

Dr. Nikhil Prabhu ( Diabetes Specialist )

Dr Nikhil Prabhu is a consultant Diabetologist from mumbai. he has been practicing for more than 10 years and currently over 7000 patients are under his treatment for diabetes and thyroid disorder from mumbai and navi mumbai area. | you can book his appointment for tele-consultation on 9082523295 | follow us on YouTube for more diabetes & health related tips

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Which Anti-Diabetes Medicines can Cause Low Blood Sugars or Hypoglycemia?

What is Hypoglycemia ?

When blood glucose level falls below 70mg/dl, person feels dizziness, headaches, sweating, confusion, anxiety symptoms, which relieve immediately after restoring blood glucose level to normal is known as Hypoglycemia.

Hypoglycemia
Credits: Oliveviewim.org

Common Symptoms of Hypoglycemia includes :

  1. Adrenergic Symptoms of hypoglycemia :

    • Hunger
    • Faintness
    • Weakness
    • Sweating
    • Palpitations
    • Tremors
    • Tingling
    • Nervousness
    • Numbness around mouth

     

  2. Neuro-glycopenic Symptoms : may require help or assistance from another person.

    • Headache
    • Double Vision
    • Lack of co-ordination
    • Inappropriate behavior
    • Confusion
    • seizures
    • Coma
    • Permanent Brain Damage & Death

Which Anti-Diabetes Medicines can cause Low blood Sugars or Hypoglycemia?

Most common is Insulin. Any type of insulin or its analogues can cause hypoglycemia.

Most commonly used insulin includes Premixes like Mixtard 30/70, Huminsulin 30/70, Novomix 3o, Humalog 25/75, regular insulin like Human Actrapid, Huminsulin R. etc or Fast acting analogues like Novorapid, Apidra, Humalog etc

Long & intermediate acting insulin & analogues like Glargine (Lantus), Detemir ( Levemir) Degludec (Tresiba), NPH, Huminsulin N etc.

In case of oral medication, those oral anti-diabetes tablets which increases insulin secretion (insulin secretagogues) from pancreas can cause hypoglycemia.

Most commonly used Insulin secretagogues includes:

  1. Sulphonyureas:

    • Glibenclamide – Daonil, Glucored, Semi daonil, etc.
    • Glimeperide – Amaryl, Zoryl, Glimestar, Glimy, Azulix, Euglim, Glimiprex, Glucoryl, etc.
    • Gliclazide – Reclide, meclazide, diamicron, Glizid, Diabend, Dianorm, Glycinorm, etc.
    • Glipizide – Glynase, Semi-glynase, Lipi, etc.
  2. Glinides:

  • Repaglinide – Eurepa, Novonorm, Repa, Regan, etc.
  • Nateglinide – Glinate, Natiz, etc.

Other anti diabetic medicines like metformin (Glyciphage, Cetapin, Metsmall, etc.), Pioglitazone (Pioz, piopar, etc.), Alfa – glucosidase inhibitors like voglibose ( PPG, Volibo, Advog, Prandial,Volix, etc.), Acarbose (Glucobay, etc.),  DPP4 inhibitors including sitagliptin ( Zita, Istavel, Januvia, etc), Viladgliptin ( Galvus, Zomelis, etc) , Saxagliptin ( Onglyza), Linagliptin ( Trajenta) , Teneligliptin (zetaplus, tenglyn, dynaglipt) even newer addition to the list SGLT2 Inhibitors like Empagliflozin (jardiance, gibtulio), Dapagliflozin (forxiga, oxra, glidepa), canagliflozin (sulisent, invokana) or remogliflozin (remo, remozen, zucator, reniva) , DO NOT Cause Hypoglycemia when given alone or in monotherapy but can cause hypoglycemia when given in combination with insulin secretagogues or with insulin.

If you found this article useful, please share it with your friends & family. I appreciate the feedback and encouragement.

Awareness is Prevention.

Dr. Nikhil Prabhu ( Diabetes Specialist )

Dr Nikhil Prabhu is a consultant Diabetologist from mumbai. he has been practicing for more than 10 years and currently over 7000 patients are under his treatment for diabetes and thyroid disorder from mumbai and navi mumbai area. | you can book his appointment for tele-consultation on 9082523295 | follow us on YouTube for more diabetes & health related tips

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Darkening behind neck – Sign of Diabetes?

Many overweight & obese people have darkening behind neck , darkening in armpits and other parts of body with creases and folds like elbows, knees, knuckles, etc. which is commonly mistaken as smudge of dirt or uncleanliness or lack of hygiene . Some people think that it is due to repeated friction caused by necklace or chains etc. In fact it is a sign of Diabetes which is already developed or going to develop.

Acanthosis Nigricans

 

This darkening is due to excessive cell growth & differentiation of fibroblasts  caused by excess of insulin in the body especially in obese individuals and type 2 diabetes patients.

In Obese individuals and Type 2 diabetes patients excess amount of fat especially abdominal fat ( Tummy fat ) causes resistance to action of insulin secreted by pancreas and hamper its action. in return body produces more and more insulin from pancreas to keep blood sugar under control. This excess amount of insulin secreted by body promotes this skin cell growth and which leads to acanthosis nigricans.

After producing excess amount of insulin pancreas start exhausting and which leads to developing diabetes.

At this stage diabetes can be prevented by simple lifestyle modification & moderate weight loss.

Other commonly experienced warning signs & symptoms already mentioned in my previous article.

Keeping in mind that complications caused by diabetes on damaging retina, kidney, nerves , heart , vascular system etc and money burden caused by treatment, it is important to STOP DIABETES here.

Lifestyle Modification includes:

  • Replacing refined carbohydrates with whole grains foods.
  • Increase intake of fresh fruits , vegetables and other foods high in fibre content.
  • Decrease saturated fat intake like avoiding chips,biscuits,pastries, Samosas, Vada pav etc.
  • Increase intake of grilled & steammed food instead of frying and roasting.
  • Reducing Amount of meal at a time ( Portion size ) cuts down calorie intake.
  • Atleast daily 30 min moderate exercise including brisk walking, cycling etc.
  • Gradual Weight loss to keep BMI in range of  18- 23  ( for Indians )
  • Stress management with yoga, meditation etc

If you show this sign, Get your blood sugar test done and consult diabetologist immediately.

 

Feel free to share this article with your friends & family.

Awareness is Prevention.

Dr. Nikhil Prabhu ( Diabetes Specialist )

Dr Nikhil Prabhu is a consultant Diabetologist from mumbai. he has been practicing for more than 10 years and currently over 7000 patients are under his treatment for diabetes and thyroid disorder from mumbai and navi mumbai area. | you can book his appointment for tele-consultation on 9082523295 | follow us on YouTube for more diabetes & health related tips

More Posts - Website

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