Today is World Diabetes Day. This day is celebrated every year on November 14 across the world. In support of raising awareness during World Diabetes Day, let’s take a look at a lesser-known complication of diabetes and major cause of blindness, diabetic retinopathy.
FEATURE ARTICLE
By Michelle Wang
People with diabetes often experience complications and one complication can lead another to worsen. Among the major diabetes complications are heart disease and stroke, kidney disease, nerve damage and amputations. However, there is one complication that people with diabetes are not commonly educated about and only start noticing when they start to lose their vision, is diabetic retinopathy (DR).
According to a research published by the National Center for Biotechnology Information in the United States, 69.0% of the study population had poor knowledge of diabetic retinopathy (Khalaf et al., 2019). This implies that a significant amount of diabetic patients have poor knowledge of DR, although nearly 1 out of 3 people with diabetes suffer from the complication (Source: WebMD).
Diabetic retinopathy is an eye condition that can cause vision loss and blindness in diabetic patients. In this condition, it causes damage to the blood vessels in the retina, which is the light-sensitive layer of tissue in the back of our eyes. The damage can cause blood vessels to swell and leak. There is also a possibility of the vessels closing which stops the blood from passing through. Chances of abnormal new blood vessels growing on the retina are also possible. All these damage causes diabetic retinopathy to steal your vision.
Types & stages of diabetic retinopathy
1. Non-proliferative diabetic retinopathy (NPDR)
This is a milder form and early stage of diabetic retinopathy. At this stage, symptoms will be mild and sometimes non-existent. Blood vessels in the retina are weakened in NPDR. Leakage of fluid in the retina may happen and this leads to swelling. Without follow-up care and treatment, patients with NPDR can develop proliferative diabetic retinopathy (DR) in a year.
Learn more about stages of NPDR here.
2. Proliferative diabetic retinopathy ( PDR)
This is the more advanced stage of diabetic retinopathy. Neovascularization happens when the retina starts growing new blood vessels. These new vessels often bleed. If only a little, you might see a few dark floaters, but if they bleed a lot, it might block all your vision. PDR have possibilities of stealing both side and central vision.
What are the symptoms?
One of the common dangers is diabetic retinopathy usually does not present any symptoms during the early stages. This has made it harder to detect unless you have an eye examination. Diabetic retinopathy (DR) usually affects both eyes. Once a diabetic retinopathy gets worse, you will start noticing the symptoms such as:
- having blurry vision
- vision sometimes changes from blur to clear, and vice versa
- seeing dark areas in your field of vision
- notice increase in number of floaters (transparent/colourless spots/ dark strings)
- experiencing poor night vision
- colour vision appears faded or washed out
- sudden or total loss of vision
Source: What Is Diabetic Retinopathy?
How to treat DR?
Treatment options depend on the severity and type of DR that you have. The response of previous treatments is also important to patients with DR. In cases of NPDR, doctors will usually monitor your eyes from time to time, which are known as watchful waiting. You will also need to work with your doctor to control your diabetes. By controlling your blood sugar level, you will have lower chances of developing into PDR. In cases of PDR, patients will most likely require immediate surgical treatment.
To learn more about the surgical treatments, read here.
How to prevent it?
People with diabetes usually develop complications over a long period of time without any symptoms. DR is usually an inevitable complication. However, you can definitely reduce your risk or help stop it from getting worse. By successfully managing your blood sugar levels, blood pressure and cholesterol levels, it can help prevent a severe form of DR.
Some of the ways are:
- Eating a healthy & balanced meal
- Exercise regularly
- Maintain a healthy body weight
- Stop smoking
- Do not exceed the recommended alcohol limit
- Attend annual diabetic eye screening appointment
- Look out for any changes to your eyesight
Source: Prevention: Diabetic Retinopathy
Diabetic patients are at risk of losing their visions and diabetic retinopathy is one of the much-feared complications of diabetes. According to the International Diabetes Federation, DR is acknowledged to be one of the leading causes of blindness in working-age adults which has caused devastating personal and socioeconomic consequences. Diabetic patients are urged to get regular eye examinations as it is crucial to get early diagnosis and treatment to prevent severe vision loss. Getting your eyes tested once you are diagnosed with diabetes will definitely keep you on the safe side.
*Michelle Wang is a contributing writer and intern at Science Media Centre Malaysia
Read more about World Diabetes Day here.