If you’ve been diagnosed with DIABETES, you've been warned about your blood sugar, your heart, your kidneys...
Having diabetes means more than just taking pills or getting injections every day. If you have diabetes, your vision is at risk. In fact, most people with diabetes who do not receive regular eye examinations will eventually lose some, if not all, of their vision.
Diabetes is a disease that occurs when the body loses the ability to digest sugar (glucose) properly. This can cause many health complications.
Diabetes affects 9.3% of the US population - that's almost 30 million people. Since the year 2000, the prevalence of diabetes has increased by over 50%.
There are two forms of diabetes: type 1, which is rare, and type 2, which is the most common and usually caused by an unhealthy lifestyle. Both types of diabetes pose a serious threat to your vision.
Type 1In type 1 diabetes, the pancreas does not make insulin like it is supposed to do, so people with type 1 need to get insulin from an injection or a pump. Anyone, at any age, can get type 1 diabetes, though it is most common in children and young adults. There is no cure for type 1 diabetes at this time.
Type 2Type 2 diabetes is the most common form and is usually caused by an unhealthy lifestyle.
In type 2 diabetes, either the pancreas does not make enough insulin or the body cannot use it the way it should. Type 2 diabetes can remain undetected for years, so people usually get diagnosed when they are older, only once they notice another health problem caused by diabetes.
Unlike type 1 diabetes, type 2 can often be managed with healthy lifestyle habits. Sometimes, healthy habits like eating a good diet and getting enough physical activity each day can even reverse type 2 diabetes by restoring normal blood glucose levels.
Diabetes is an ongoing disease that needs to be consistently kept on track so that your blood glucose levels stay normal. Abnormal levels of blood glucose can cause many health problems, affecting anything from the eyes to the feet. There are a number of strategies for maintaining normal blood glucose levels. Work with your doctor to choose the best methods for you.
[i] Stewart, MR. Critical appraisal of ranibizumab in the treatment of diabetic macular edema. Clinical Ophthalmology. 2013(7):1257–1267.
[ii] Overview of epidemiologic studies of diabetic retinopathy. Klein BE. Ophthalmic Epidemiol. 2007 Jul-Aug; 14(4):179-83
But you may not realize: Your EYES are at RISK!
Living with diabetes can be really hard. It requires a lot of daily tracking and discipline. If you don’t properly manage your diabetes, and sometimes even if you do, you may end up with other health problems. Vision loss is a major problem that you need to know about.
Among adults aged 20 - 74, diabetes is the most common cause of blindness. The CDC estimates that 28.5% of all Americans 40 years and older with diabetes — or 4.2 million individuals, have diabetic eye disease. Advanced cases of diabetic eye disease can lead to severe vision loss.
Your VISION is PRECIOUS because you need your sight to do so many important things in life.
Things we take for granted, like using the computer, reading books, driving, and getting from place to place are not possible without clear vision. Losing your vision means losing your independence and much of what makes life worth living.
Your vision is also crucial for managing your health when you have diabetes.
Whether it is cooking to ensure good nutrition, controlling your blood sugar and taking insulin, or simply getting out of the house and exercising, you need your vision in order to take good care of yourself and manage any other health complications you may be experiencing.
Having diabetes means you have HIGH BLOOD SUGAR, also known as “HIGH BLOOD GLUCOSE.”
When your body cannot digest glucose from the foods you eat, the glucose sticks to your blood, staying in your body for too long. When you have too much glucose in your bloodstream, this is called having high blood glucose (or high blood sugar). High blood glucose is the main indicator of diabetes and also the main cause of health problems related to diabetes.
Why is too much glucose a problem?
Most people with diabetes know that blood glucose can spike to dangerously high levels, which can cause sudden death. But, did you know that having even slightly high levels of blood glucose for long periods of time is also dangerous? Even just a little more glucose in your blood than normal can damage cells all over the body. If this happens, it can cause serious problems like vision loss, organ failure, or premature death.
One of the most important things you can do as a person living with diabetes is to keep your blood glucose levels as close to normal as possible.
You can prevent a lot of health problems by keeping your blood glucose levels from getting too high or too low. The ideal level will be different for everyone - work with your doctor to identify the best level for you and develop a strategy to maintain it.
HIGH levels of glucose in the blood HARMS your EYES. It can cause conditions such as Diabetic Retinopathy and Diabetic Macular Edema.
Having too much glucose in the blood can damage your eye and can cause vision-threatening eye diseases. Diabetic Retinopathy and Diabetic Macular Edema are two common eye diseases caused by diabetes that can rob you of your vision. High blood glucose can also cause cataracts over time.
Over time, excessive blood glucose causes damage to blood vessels in the eye.
There are blood vessels in the back of the eye that keep the eye healthy. When you have too much glucose in your blood, it damages these blood vessels. The damaged blood vessels can start to overgrow, or leak fluid into your eye, causing vision problems.
Diabetic Retinopathy (DR) develops when excessive blood glucose causes the blood vessels in the eye to overgrow like weeds in a garden.
Although blood vessels are important and feed oxygen and nutrients to the eye, it’s the case of “too much of a good thing.” The overgrown blood vessels can cause damage to your vision. Over time DR can develop into Diabetic Macular Edema, or DME, the most common cause of vision loss in people under 65 years old.
DR is caused by damage to the blood vessels in the retina. The retina is the special tissue at the back of the eye that allows you to see. The blood vessels in your retina keep it healthy, with a supply of oxygen and nutrients. When the body has excess blood glucose, the vessels in the retina can overgrow or become damaged, causing diabetic retinopathy.
Diabetic Macular Edema (DME) can occur with DR, when the vessels “spring a leak” like a broken garden hose, causing a flood.
Imagine the blood vessels in your eye as if they are hoses watering a garden. What happens if the hoses spring a leak? The garden gets flooded. This is exactly what happens in the eye: the vessels leak and the back of the eye gets filled with fluid and blood. This “flooding of the eye” is known as Diabetic Macular Edema (DME).
Diabetic macular edema is a complication of diabetic retinopathy. When the damaged blood vessels in the retina start to leak, it can cause swelling in the macula. The macula is the central part of the retina. It allows you to focus in the center of your vision, to do things like reading and driving. The swelling of the macula is what causes blurry and distorted vision.
Why is it called Diabetic Macular Edema?
Diabetic - this condition occurs in people with diabetes.
Macular - swelling occurs in the macula, at the center of the retina.
Edema - edema is another word for swelling, which is caused by the leaky blood vessels.
Diabetic macular edema can occur at any stage of diabetic retinopathy, but the longer you have DR, the more likely you are to progress to DME.
You might not notice that you are losing your vision. It can happen over the course of years, or it can be quite sudden!
It can take a while for high blood glucose to cause vision problems, so you may not notice symptoms right away. Not noticing symptoms until the disease progresses is a problem because treatments do not work as well once the disease is advanced. That is why annual eye exams are so important for catching early signs of damage BEFORE you notice any changes in your vision.
In fact, one eye can compensate for the other, so you might not even notice that you have a “bad” eye.
Even if you think you have perfect vision, you may have DR or DME. Vision loss can sneak up on you. If you are losing your vision in one eye, your brain will automatically compensate for those vision problems by relying on the other eye. Your vision will seem fine, but if you cover one eye at a time, you may notice changes in your vision. This is a good way to spot a problem. But the BEST possible way to spot a problem is to get screened by your eye doctor! Learn more about this in the next section.
Don’t think “IT WON’T HAPPEN TO ME...” most people with diabetes will experience some vision loss.
Many people who are diagnosed with diabetes start out believing that they can ignore their blood glucose levels as long as they watch what they eat. Some people don’t take diabetes seriously because it is so common. The longer someone has diabetes, the greater their chances are of getting DR and DME. It’s natural to think, “it won’t happen to me” but, if you have diabetes, the danger is real and it has serious consequences.
Roughly 1-in-3 people with diabetes develop DR, and about 1-in-10 suffer from DME.
Diabetic Retinopathy is a serious condition—it’s the #1 cause of blindness among adults (ages 20-74 years) around the world. In fact, at least 93 million people live with Diabetic Retinopathy, and 21 million people have DME worldwide. Anyone with type 1 or type 2 diabetes is at risk, even young people. This means everyone should get a comprehensive eye exam each year to test for DR and DME.
But don’t just take it from us. Listen to other folks with diabetes who have stories to share.
Most people with diabetes will lose some, if not all of their vision. These community members have been brave enough to share their stories as cautionary tales. The message is: take care of your health, control your blood glucose, and get a dilated eye exam with your eye doctor at least once a year if you have diabetes.
The good news is: you don’t have to lose your vision.
The best way to prevent vision loss is to control your blood glucose levels and get eye exams every year. Eye exams can catch early signs of eye damage, allowing it to be treated before vision loss occurs. If you have DR or DME, early treatment is the best way to keep it from taking away your vision. Talk with your doctors to learn about the many ways that diabetes can affect your life, and develop a strategy for protecting your vision.