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Other ways diabetes can affect your eyes
Temporary blurring
The unusual changes in blood sugar levels resulting from diabetes can affect the lens inside the eye, especially when diabetes is uncontrolled. This can result in blurring of vision which comes and goes across the day. This blurring may be one of the first symptoms of diabetes although it may also occur at any time when your diabetes is not well controlled. Once your diabetes is controlled most people find this variable blurring goes away.
Cataracts
A cataract is a clouding of the lens of the eye, which causes the vision to become blurred or dim because light cannot pass easily to the back of the eye. This is a very common eye condition that often develops as we get older, but people with diabetes sometimes develop cataracts at an earlier age. An operation can remove the cloudy lens, which is usually replaced by a plastic lens, helping the eye to focus properly again. Your eye clinic will monitor a cataract if it is forming as part of your regular check up.
Important points to remember
• Early diagnosis of diabetic retinopathy is vital.
• Attend your annual diabetic eye screening appointment.
• Don't wait until your vision has deteriorated to have an eye test.
• Speak to your diabetic eye clinic if you notices changes to your vision.
• Most sight-threatening diabetic problems can be managed by laser treatment if it is done early enough.
• Don't be afraid to ask questions or express fears about your treatment.
• Good control of sugar, blood pressure and cholesterol reduces the risk of diabetes-related sight loss.
• Attend your diabetic clinic or GP surgery for regular diabetes health checks, including blood pressure and cholesterol monitoring.
• Smoking increases your risk of diabetes-related sight loss. Your GP can tell you about NHS stop smoking services in your area.
Monitoring blood sugar levels
Home testing your blood sugar levels is a very effective way of making sure you are controlling your blood glucose. You prick the side of a finger and place a drop of blood on a testing strip. You put the strip in a glucose meter which displays your blood glucose level on a screen.
If you have a sight problem you might find some meters difficult to read. However, you can now get easier to see meters and talking meters. Up-to-date details of meters are available from Diabetes UK or you can call the Diabetes UK Careline on 0845 120 2960, Monday to Friday, 9am to 5pm.
If you are having difficulties reading your meter at home tell someone involved with your diabetic care. You need to be able to carry out testing at home accurately and your diabetic nurse needs to work with you to ensure that you can use the meter you have chosen effectively.
What if my sight is permanently affected?
Much can be done to help you use your remaining vision. You should ask your eye specialist or optometrist about low vision aids. Alternatively, you could contact the RNIB Helpline on 0303 123 9999 .
If your vision is impaired, it is also worth asking your specialist to help you register as "sight impaired" or "severely sight impaired". This opens the door to expert help and some financial concessions.
Being diagnosed with an eye condition can be very upsetting. You may find that you are worried about the future and how you will manage with a change in your vision. All these feelings are natural. Some people may want to talk over some of these feelings with someone outside their circle of friends or family. RNIB can help with our telephone Helpline and emotional support service. Your GP or social worker may also be able to find a counsellor for you, if you think this would help.
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Why diabetes occurs
Diabetes occurs because the body can't use glucose properly, either owing to a lack of the hormone insulin or because the insulin available doesn't work effectively.
The full name diabetes mellitus derives from the Greek word diabetes meaning siphon - to pass through - and mellitus, the Latin for honeyed or sweet. This is because not only is excess sugar found in the blood but it may also appear in the urine, hence it being known in the 17th century as the 'pissing evil'.
According to the charity Diabetes UK, more than two million people in the UK have the condition and up to 750,000 more are believed to have it without realising they do.
More than three-quarters of people with diabetes have type 2 diabetes mellitus. This used to be known as non-insulin dependent diabetes mellitus (NIDDM) or maturity-onset diabetes mellitus. The number of people with type 2 diabetes is rapidly increasing as it commoner in the overweight and obese, which is itself a growing problem.
The remainder have type 1 diabetes mellitus, which used to be known as insulin-dependent diabetes mellitus.
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Type 1 diabetes
In type 1 diabetes, the body is unable to produce any insulin.
It usually starts in childhood or young adulthood, and is treated with diet control and insulin injections.
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Type 2 diabetes
In type 2 diabetes, not enough insulin is produced or the insulin that is made by the body doesn't work properly.
It tends to affect people as they get older and usually appears after the age of 40, but increasingly is seen in younger, overweight people.
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Normal blood sugar control
The body converts glucose from food into energy. Glucose comes ready made in sweet foods such as sweets and cakes, or from starchy foods such as potatoes, pasta or bread once they're digested. The liver is also able to manufacture glucose.
Under normal circumstances, the hormone insulin, which is made by the pancreas, carefully regulates how much glucose is in the blood. Insulin stimulates cells to absorb enough glucose from the blood for the energy, or fuel, that they need. Insulin also stimulates the liver to absorb and store any glucose that's left over.
After a meal, the amount of glucose in the blood rises, which triggers the release of insulin. When blood glucose levels fall, during exercise for example, insulin levels fall too.
A second hormone manufactured by the pancreas is called glucagon. It stimulates the liver to release glucose when it's needed, and this raises the level of glucose in the blood.
Insulin is manufactured and stored in the pancreas, which is a thin gland about 15cm (6in) long that lies crosswise behind the stomach. It's often described as being two glands in one, since in addition to making insulin it also produces enzymes that are vital for digestion of food.
These include lipase, which helps to digest fat, and amylase that helps to digest starchy foods. It also releases 'bicarbonate of soda' to neutralise any stomach acid that may otherwise damage the lining of the gut.
Diabetes that isn't controlled can cause many serious long-term problems. Excess glucose in the blood can damage the blood vessels, contributing to heart disease, strokes, kidney disease, impotence and nerve damage.
Uncontrolled diabetes is the most common cause of blindness in people of working age. People with diabetes are also 15 per cent more likely to have an amputation than people without the condition.
In most cases, it's possible to reduce the risk of such complications by following medical advice and keeping diabetes under control. It's vitally important for people with diabetes to check their glucose levels regularly at home and to attend GP, diabetes nurse or hospital check-ups, so any problems can be detected and treated early.
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How is diabetes diagnosed?
Diabetes may be detected during a routine urine test when excess glucose is present.
When symptoms have drawn attention to the problem, blood tests such as a glucose tolerance test to look at insulin response, and an HbA1c test to look at long-term sugar levels will confirm whether or not the underlying cause is diabetes.
Antenatal screening is not possible.
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Who's affected by diabetes?
Those at risk include:
• People over 40, or over 25 and African-Caribbean, Asian or from a minority ethnic group
• People with a close family member who has type 2 diabetes
• People who are overweight or who have a large waist size
• Women with polycystic ovary syndrome who are overweight
• Women who've had diabetes in pregnancy (gestational diabetes)
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What's the treatment for diabetes?
It's recognised that the sooner the blood sugar levels are brought under control, the better the long term prospects of preventing damage. Lifestyle advice about diet, weight management and regular activity is the first step. Type 1 diabetes will require immediate insulin therapy, Type 2 diabetes will first be managed with a drug called Metformin, if lifestyle changes alone aren't effective. There are now several other drugs used in type 2 diabetes, although eventually some type 2 diabetics will need insulin therapy as it's a progressive disease.
Although no cure exists for type 1 diabetes, its symptoms can be eliminated by adhering to a healthy diet that has a controlled amount of sugar in it, and by having regular injections of insulin to replace that which the body is not providing. This aims to keep the blood glucose level steady.
Insulin can't be taken by mouth because digestive juices and enzymes destroy it before it can get into the bloodstream. Scientists are working on ways of overcoming this.
Most people find giving themselves the injections simple and painless, as the needle is so fine. How often someone needs to inject insulin depends on what their diabetes specialist has recommended and which type of insulin they're using.
Insulin can be short-acting, medium-acting or long-acting. Some people need it twice a day, some three times a day and some use an insulin pen to give themselves insulin just before meals.
Devices are becoming available that deliver insulin continuously under the skin in response to need. Inhaled insulin is also available.
Self-help
• Monitor blood glucose levels
• Attend hospital check-ups
• Have regular eye checks
• Inform the DVLA
• Wear a medi-alert bracelet
• Always have some sugar available
Many people with type 2 diabetes need only to eat a healthy diet to control their diabetes. If this isn't enough, medication or insulin may be necessary.
Everyone with diabetes should eat a diet that's low in fat, sugar and salt.
Regular exercise, not smoking and keeping to an ideal weight also help prevent the complications of diabetes, such as heart disease. Keeping blood pressure at a safe level is important.
People with type 1 diabetes are allowed to drive, but must inform the DVLA that they have diabetes. If blood sugar goes too low, they may develop hypoglycaemia.
Most wear an identity bracelet to inform people they have diabetes in case they black out and need help.
Fortunately, diabetes can be managed well, so people can live a normal lifestyle.
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Diabetes and your eye
Diabetes can affect your eye in a number of ways:
• The most serious eye condition associated with diabetes involves the network of blood vessels supplying the retina. This condition is called diabetic retinopathy.
• The unusual changes in blood sugar levels resulting from diabetes can affect the lens inside the eye, especially when diabetes is uncontrolled. This can result in blurring of vision which comes and goes over the day, depending on your blood sugar levels.
• A longer term effect of diabetes is that the lens of your eye can go cloudy, This is called a cataract.
Not everyone who has diabetes develops an eye complication. Of those that do, many people have a very mild form of retinopathy which may never progress to a sight threatening condition.
Diabetic retinopathy
The most serious complication of diabetes for the eye is the development of diabetic retinopathy. Diabetes affects the tiny blood vessels of the eye and if they become blocked or leak then the retina and possibly your vision will be affected. The extent of these changes determines what type of diabetic retinopathy you have. Forty per cent of people with type 1 diabetes and twenty per cent with type 2 diabetes will develop some sort of diabetic retinopathy.
Background diabetic retinopathy
This is the most common type of diabetic retinopathy and many people who have had diabetes for some time will have this early type. The blood vessels in the retina are only very mildly affected, they may bulge slightly (microaneurysm) and may leak blood (haemorrhages) or fluid (exudates). As long as the macula is not affected, vision is normal and you will not be aware that anything is wrong. Your retinal screening test will keep a close check on these early changes and ensure that any signs of progression to more serious stages of retinopathy are detected early.
Maculopathy
Maculopathy means that your macula is affected by retinopathy. If this happens, your central vision will be affected and you may find it difficult to see detail such as recognising people's faces in the distance or seeing detail such as small print. Most maculopathy can be treated with laser with the aim of preserving as much vision as possible. The amount of central vision that is lost varies from person to person. However, the vision that allows you to get around at home and outside (peripheral vision) is not affected.
Proliferative diabetic retinopathy
If diabetic retinopathy progresses, it can cause the larger blood vessels in the retina to become blocked. These blockages can result in areas of the retina becoming starved of oxygen. This is called ischaemia. If this happens the eye is stimulated into growing new vessels, a process called neo-vascularisation. This is the proliferative stage of diabetic retinopathy, and is nature's way of trying to repair the damage by growing a new blood supply to the oxygen starved area of your retina.
Unfortunately, these new blood vessels are weak, and grow in the wrong place - on the surface of the retina and into the vitreous gel. As a result, these blood vessels can bleed very easily which may result in large haemorrhages over the surface of the retina or into the vitreous gel. These types of haemorrhages can totally obscure the vision in the affected eye as light is blocked by the bleed. With time the blood can be reabsorbed and vision can improve.
Extensive haemorrhages can lead to scar tissue forming which pulls and distorts the retina. This type of advanced diabetic eye disease can result in the retina becoming detached with the risk of serious sight loss.
Only between 5 and 10 per cent of all diabetics develop proliferative retinopathy. It is more common in people with type 1 diabetes than type 2. Sixty per cent of type 1 diabetics show some signs of proliferative disease after having diabetes for 30 years.
Reducing risk
We have divided the risk factors for developing diabetic retinopathy into those you are able to control and those you cannot. Good diabetic control significantly lowers your risk of retinopathy
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Got this out of a diabetics recipe book but never tried it, think it would be too sweet for me
Peach and Raspberry Yogurt Fool
Serves 4
2 peaches, 8 oz raspberries, 4 of 150ml/5fl oz pots low-fat natural or low fat low sugar fruit yoghurt, 220ml/4 tspn porridge oats, 20ml/4 tspn flaked almonds
Cut the peaches in half, remove the stones and then slice the flesh into thin wedges.
Mix the peaches and raspberries with the yoghurt in a bowl, then spoon into 4 sundae glasses and chill.
Spread out the porridge oats and almonds in a grill pan. Grill until lightly toasted, shaking the pan frequently. Cool, then sprinkle the oat mixture over the desert and serve.
This works well with strawberries, apricots, kiwi fruit, pears, bananas or pineapple chunks. Match with a fruit yoghurt of the same flavour, or a complementary variety.
Sugar total = 18.3 and carbohydrate 21.65g
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Think that's enuff info for 2nite. More another nite incl a recipe for Brack.
Had a good gym session 2day but then started a hypo at 5pm - not nice. 2 rounds of erzte cheese (miniCol) on toast, each round with a large dollop of tomato sauce on top (to provide a sugar lift) sorted that
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Thank you for the info, it takes some digesting. I hope you will be feeling better tomorrow Ronald
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Ello Paula - hypos are short lived provided you recognise that you're experiencing one, if you dont you go into a sort of coma and need help from professionals - can kill of course. My very bad one - sugars down to 3.8 (Normal is about 4.5)cleared up immediatley after scoffing a small bar of choccy
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This Recipe taken from “Real Food For Diabetics” by Molly Perham, published by
foulsham
BRACK BREAD (a piece of this is a belly filler!)
This is a cross twixt fruit cake and fruit loaf. It is a very dense bread but stops those hunger pangs.
The book recommends a slice of Brack as a mid –morning snack or with afternoon tea,
spread with sunflower or other low fat spread. I personally don’t use spread on it.
Brack freezes OK and doesn’t acquire a ‘freezer’ taste. If freezing recommend that
loaf be sliced first and insert greaseproof paper twixt each slice prior bagging.
Makes it easy then just to take a slice at a time from the freezer.
Brack ‘travels’ OK and when on a day out I usually take a couple of slices with me
or a couple of muffins.
NB: Shop bought Brack is VERY high in sugar content
INGREDIENTS FOR ONE LOAF (USING A 2lb LOAF TIN)
1lb of dried mixed fruit – OR mix your own leaving out any particular fruit you don’t
like. Ie We use raisins and sultanas only.
8 fl ozs (1 cup) cold tea (milkless!) Strength of tea is up to you.
8 oz WHOLEMEAL Self Raising Flour.
1 egg (beaten)
METHOD
1. Put the dried fruit into a bowl, pour over the tea and leave to soak overnight.
2. Note: We tried just soaking for 3-4 hours but made brack taste bitter.
3. Next day preheat oven to 150C/300F/Gas Mark 2
4. Mix together the fruit, flour and egg. Spoon into a well greased and lined loaf tin.
5. Bake for two (2) hours. Turn out and leave to cool before cutting.
PREPARATION AND COOKING TIME
Two (2) hours and a few minutes plus overnight soaking for the fruit.
Note: A lady to whom I gave this recipe also tried it using white flour which made
the Brack a much lighter loaf. Was nice as I tried some. But,(Always a ‘but’)
wholemeal products are recommended for Diabetics as helps to stabilise blood sugar levels.
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Hello Ronald. Than you for recipe I am printing them off and hopefully I will get round to baking soon.
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For Paula and Granny - wot is "borderline diabetes"? Is it something based on a test of long term sugars?
I was just told in 2002 that I had Type 2 and needed to diet and exercise. Over the years my daily blood tests went from around 4.8 to (current average) 6.4. Dunno wot my long term bloods were in 2002 but 2 years ago they exceeded the then limit of 7 so had to start medication. Goal posts since moved and long term bloods limit pre drugs now 6.8
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GP told us is was called"borderline" People with prediabetes have glucose levels that are higher than normal but not high enough yet to indicate diabetes. The condition used to be called borderline diabetes. Most people with prediabetes don't have symptoms, but they are considered to be at high risk of it developing.
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Diabetes and Eating Too Fast
Eating too fast can increase the risk of piling on the pounds. Now according to the Lithuanian University of Health Sciences, it may more than double your risk of developing Type 2 diabetes. It’s not yet known exactly why but the message is to slow down and savour each bite.
Above Item from Saga Mag.
I didn't eat fast as in 1997 after removal of a kidney due cancer was warned to thoroughly chew food from then on and to take my time doing so. Still got diabetes in 2002 tho
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Ok, I admit it, I am still in the denial stage and I think I will be for the foreseeable future. So I haven't read this thread but I really need this question answered, and I am sure someone here will know the answer.
Here in front of me I have a bottle of Diet Mountain Dew, which is apparently NEW, 1 g sugar, 1 g carbohydrate, good right. But I have heard that Aspartame is bad for you. I used to drink Ginger ale a lot, so I reaaaaaaaaaaally need to find one that I can drink without to many consentiences.
So, is Aspartame bad for you?
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Hi RMS
haven't see you for ages!
Hope you are OK.
Re Aspartame ....................... in my own humble opinion, yes, it is bad for you.
I never drink diet drinks, or anything else, that has Aspartame in it if I can possibly help it.
Having said this ............. there are a number of scientific studies that show that aspartame is safe at current recommended levels.
The Center for Disease Control in the US investigated an email that was going round saying that aspartame was responsible for a large number of diseases ............... and was unable to find any significant connection between any disease and aspartame
I guess you pays your money and takes your chances.
I have to say that I also find that I can tell from the taste when aspartame has been used, and don't like that taste.
The advice that I was given earlier in the summer when I was diagnosed as pre-diabetic was to drink unsweetened fruit juices in small quantities and lots of water.
sylvia
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