Diabetes is a chronic health condition that occurs due to a fault in one’s insulin capacity to regulate blood sugars making their levels too high. Although diabetes has two forms, type 2 is more common. In type 1 is the body’s immune system attacks the cells that produce insulin while in type 2, the body does not generate insulin or its cells do not react to the hormone (National Health Services, 2017). Although blindness is a relatively rare complication of diabetes, a 2017 report by the CDC reveals that about 11% of American diabetes patients aged 20 and above have developed some form of visual impairment where 3.8% of the cases result in total blindness (Center for Disease Control,2017). My objective is to inform people on good diabetic practices to avoid ocular complications related to diabetes, particularly retinopathy as it is the most common, because as a fact these eye diseases are easily treatable and can be kept from developing into full-blown blindness if discovered in the early stages.
Reasons for Selecting This Topic
Being blind myself I understand the inconveniences that come with my condition, primarily if it is acquired in adulthood as it requires a lot of adjustments to be able to lead a normal life without being a burden to others. Most of my relatives have diabetes, and this means that they are at risk to develop various eye complications related to the condition. Diabetes affects a lot of people. According to the CDC (2017), in America alone, by 2015, about 30.3 million people of all ages had diabetes. This translates to 9.4 % of the entire population and 12.2 % of the adult population where 23.8% or 7.2 million were not even aware that they had diabetes. Although the percentage of diabetes patients increases with age where most patients are older than 65 years, children below 18 years are often diagnosed with the condition and usually type 1. Between 2011 and 2012, newly diagnosed cases in the United States included some 17,900 patients below the age of 20 with type 1 and 5,300 aged 10-19 with type 2 diabetes (CDC, 2017). While type 1 is closely linked to hereditary causes, type 2 is associated with lifestyle choices such being overweight. Since diabetes is untreatable, that is a lot of people who are at risk of going blind is their condition is not well managed (NHS, 2017).
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From the above data collected in the United States alone, it is clear that diabetes is a real problem affecting people across all age groups. Therefore, since most adults that develop blindness is as a result of diabetes, it is essential to review the steps that can be taken to keep this from happening. Two major visual complications come with diabetes: diabetic retinopathy and diabetic macular edema (DME). Although quite rare, cataracts and glaucoma may also develop in diabetes patients (Prevent Blindness, 2017).
Diabetic retinopathy is the most common visual complication, and it may appear in either of two forms namely, non-proliferative or proliferative diabetic retinopathy. The first one occurs during the early stages of the disease where capillaries in the retina weaken and break, leaking fluid into the retina that interferes with the refraction of light in the eye. The other one is an advanced form of the disease where the broken vessels become blocked and causing oxygen deprivation to parts of the retina and thus tissue death (WebMD, 2017). The fluid leak in the retina can collect around the macula which causes swelling in this area called diabetic macular edema. The macula is enables central and detailed vision, and its damage causes blurred vision (American Optimetric Association, 2009).
Application in Real Life
While various forms of diabetic eye disease can cause blindness, they can also be easily corrected using laser surgery or injectable medicines. However, this is only possible if the problem is detected early enough. According to the American Diabetes Association, any diabetic aged 12 and above should have their eyes checked at least once a year. This is a straightforward procedure that takes about half an hour and involves dilating the pupil to check the back of the eye to see if there are any complications (American Optimetric Association, 2009). An ophthalmologist can use a focused laser beam to close off the leaking blood vessels or prevent the growth of rogue capillaries before they cause irreversible damage (Fighting Blindness, 2017). Closely monitoring blood sugar, blood pressure, cholesterol, and regular exercise can also reduce the risk of developing visual complications for people with diabetes (Payne, 2010).
Recent technology has allowed the development of injectable drugs that are used to treat DME such as anti-VEGF (Vascular Endothelial Growth Factor) drugs which stop the abnormal growth of blood vessels in the retina by blocking VEGF production (Fighting Blindness, 2017). The National Eye Institute and other institutions like the Mater Hospital are researching to come up with an efficient way to detect diabetic retinopathy in its early stages and prevent the development of blindness in people with diabetes. The adaptive optics (AO) technology is used for this purpose as it filters out distortions to detect small changes in the retinal structure. Such advances will help to significantly reduce the number of diabetics that end up with blindness by treating eye diseases before they become severe (NEI, 2015).
References
American Optimetric Association. (2009). Diabetic Retinopathy. Retrieved from https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/diabetic-retinopathy
Center for Disease Control(CDC). (2017). National diabetes statistics report (1-20). Retrieved from https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
Fighting Blindness. (2017). Diabetes-related sight loss. Retrieved October 10, 2017, from https://www.fightingblindness.ie/eye-conditions/diabetic-retinopathy/
National Eye Institute (NEI). (2015). Facts About Diabetic Eye Disease | National Eye Institute. Retrieved from https://nei.nih.gov/health/diabetic/retinopathy
National Health Services (NHS). (2017). Diabetes - NHS Choices. Retrieved from http://www.nhs.uk/Conditions/Diabetes/Pages/Diabetes.aspx
Payne, J. W. (2010). Got Diabetes? Do These Things or You May Go Blind Diabetic retinopathy causes the most cases of adult blindness in the U.S. Here are 5 ways to prevent it. Retrieved from https://health.usnews.com/health-news/family-health/diabetes/articles/2010/06/27/got-diabetes-do-these-things-or-you-may-go-blind
Prevent Blindness. (2017). Diabetes and Your Eyes | Prevent Blindness. Retrieved from https://www.preventblindness.org/diabetes-and-your-eyes
WebMD. (2017). How Diabetes Causes Blindness-Topic Overview. Retrieved from https://www.webmd.com/diabetes/tc/how-diabetes-causes-blindness-topic-overview#1
