Diabetes is a serious health condition that affects more than 1 in 10 adults worldwide. One of its biggest risks is damage to the eyes, leading to a condition called diabetic retinal disease (DRD). This disease is the most common cause of preventable blindness in people between the ages of 20 and 74.
The problem with DRD is that it often starts without any symptoms. Many people don’t realize they have it until their vision is already affected. This makes regular eye checkups very important, but many people with diabetes don’t go for screenings because they don’t feel anything is wrong.
Dr. Thomas Gardner, a professor and diabetes expert, recently wrote about this issue in a medical journal. He explained how diabetes damages different parts of the body, including the kidneys, nerves, and eyes. In the case of DRD, diabetes harms the tiny blood vessels and nerve cells in the retina, which can cause bleeding, abnormal blood vessel growth, and loss of important nerve cells.
According to Dr. Gardner, many people only take action when their vision starts to get worse. But by that time, the disease may already be in its late stages, making treatment more difficult.
To prevent this, the American Diabetes Association recommends that people with type 2 diabetes get an eye exam as soon as they are diagnosed. Those with type 1 diabetes should have their first eye exam within five years of diagnosis.
The reason for this difference is that type 2 diabetes often goes unnoticed for years, meaning eye damage may already have started before diagnosis. Younger people with diabetes, especially teenagers and young adults, are at an even higher risk because controlling blood sugar is particularly hard for them.
Managing diabetes requires constant attention to blood sugar levels, diet, and lifestyle. However, even when people eat the same food, take the same medication, and exercise regularly, their blood sugar levels can still change unexpectedly. This makes diabetes difficult to control.
A major challenge is keeping blood sugar levels low without going too far and causing hypoglycemia, which can lead to dizziness, shakiness, sweating, and an irregular heartbeat. Fortunately, new technologies like insulin pumps and continuous glucose monitors have made managing blood sugar easier.
Dr. Gardner stresses that diabetes care is about more than just blood sugar. People with diabetes need regular health checkups to monitor their blood pressure and make sure their organs are working properly. Taking care of all aspects of diabetes is the best way to prevent complications like DRD.
Although scientists don’t fully understand how diabetes damages the retina, they have found several drugs that may help slow the disease. Some medications, originally made for kidney disease, heart disease, and high cholesterol, have also been found to protect vision in people with diabetes.
These include drugs that control blood pressure and cholesterol, such as SGLT inhibitors, GLP-1 receptor activators, and fenofibrate. However, these medicines are usually prescribed by general doctors, not eye doctors.
Dr. Gardner and his team at the Caswell Diabetes Institute are working to develop better ways to catch DRD early and find new treatments to protect vision. He says the future looks hopeful. With regular screenings and proper treatment, people with diabetes have a much better chance of avoiding vision loss than ever before.
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The research findings can be found in Diabetes Technology & Therapeutics.
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