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Diabetes and your eyes

It is unfortunate that more and more women are being diagnosed with diabetes in South Africa than ever before. The reason for this can be directly linked to not only a genetic predisposition but also the lifestyle that we lead. Our modern hectic way of living causes us to invite diabetes unwittingly into our lives. I will briefly explain a few basics with regards to diabetes before mentioning the effect it may have on your eyes and why it is important to make sure it is diagnosed early, treated properly and well-controlled. Diabetes has no cure and is a life-long condition that requires careful management.

Different types of diabetes:
1. Type 1: Insulin-dependent diabetes:
The exact cause of type 1 diabetes is unknown. In most people with type 1 diabetes, the body’s own immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet) cells in the pancreas. Genetics may play a role in this process, and exposure to certain environmental factors, such as viruses, may trigger the disease. Insulin is a hormone that’s needed to control the amount of sugar (glucose) in the blood. In type 1 diabetes, there’s no insulin to let glucose into the cells, so sugar builds up in the bloodstream, where it can cause life-threatening complications. Type 1diabetes used to be thought to occur mainly in children (early onset) but more and more cases of adult onset Type 1 diabetes are occurring. Because the body no longer produces any insulin, the insulin has to be injected in order for the glucose to be able to reach the cells from the bloodstream. The amount, type and how many times a day it needs to be injected varies from person to person.

2. Type 2: Non-insulin dependent diabetes:
About 90 per cent of people with diabetes have Type 2 diabetes. Unlike people with type 1 diabetes, people with type 2 diabetes produce insulin; however, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly (insulin resistance). When there isn’t enough insulin or the insulin is not used as it should be, glucose (sugar) can’t get into the body’s cells and builds up in the bloodstream instead. When glucose builds up in the blood instead of going into cells, it causes damage in multiple areas of the body. Also, since cells aren’t getting the glucose they need, they can’t function properly. Type 2 diabetes is believed to have a strong genetic link, meaning that it tends to run in families. Although there is a strong genetic predisposition, the risk is greatly increased when associated with lifestyle factors such as high blood pressure, being overweight or obese, insufficient physical activity, poor diet and the classic ‘apple shape’ body where extra weight is carried around the waist. This “apple shape” is very common in women who carry extra weight. Aging also increases the risk of Type 2 diabetes. Our hectic, fast-paced lifestyle fuels bad eating habits, stress and lack of exercise. Women (especially those who have children and families to look after), usually look after themselves last. They delay seeking medical attention and often burn the candle at both ends.
Unfortunately Type 2 diabetes is a quiet disease and can be present for many years without being aware of it.Treatment involves oral medications, change of diet, increased exercise and improvement of general health.

3. LADA (latent autoimmune diabetes in adults) Type 1.5:
Scientists have identified several other diabetes subtypes beyond types 1 and 2. The most common of these is called latent autoimmune diabetes in adults (LADA).

What role do your eyes play in diabetes?
It is often said that the eyes are the window to the soul. This could not be more accurate than in the case of diabetes. The eyes are the only place where we can directly see the effects of diabetes on the blood vessels and cells without having to cut someone open. Also the eyes can provide an early detection system for diabetes since one of the first signs/symptoms is blurry, fluctuating vision. An increase in blood glucose causes you to become more short-sighted. So if all of a sudden your distance vision becomes blurry when it was clear before and you can suddenly read without needing your reading glasses (if you had some), you need to visit your optometrists immediately! They will then re-assess your vision and some optometrists are trained to even check your blood glucose levels. Also, even a routine visit for an eye exam can lead to a diagnosis of diabetes even if your vision has not appeared to be changing. When examining the back of the eye, the optometrist can see any damage to the small blood vessels or see other tell-tale signs of diabetes.

If you already have diabetes it is incredibly important to make sure you have regular eye exams. This is not necessarily to get new spectacles but to examine the retina (back neural layer in the eye) for any damage due to diabetes. There could be small bleeds in the back of the eye and if they are occurring in the eye, chances are they are also happening elsewhere (like in the kidneys). Your eyes function as a window on the rest of your body and mirror changes happening elsewhere, so have them checked regularly! If bleeding or other changes are seen by your eye care practitioner, you will be sent to have further investigation and might need laser repair or other intervention to save your vision. If it is not addressed and treated early, blindness will eventually follow. So don’t delay, go visit your eye doc today!

If you require more information about any of the information in this article please feel free to contact me at 011 680-3400 or
Leoni Joubert Optometrist.
Southdale Shopping Centre.

Born to Shine Magazine