Diabetic retinopathy, when tiny blood vessels inside the retina are damaged by diabetes, is the most common diabetic eye disease, and is the chief cause of adult blindness in the United States. Yet it's a problem that can be prevented or slowed if warning signs are heeded and steps are taken early to ward off the condition. Symptoms include blurry or double vision, pain or pressure in the eyes, problems seeing out of the corners of the eyes, as well as seeing flashing lights, rings, or dark or floating spots. People with diabetes are also at higher risk for developing cataracts and glaucoma, and at a younger age than those who don't have diabetes.
So what can you do to prevent diabetes-related eye complications? Start by making it a lifelong goal to take proper care of your condition, experts recommend. Their advice:
Closely monitor your blood sugar. Because diabetic retinopathy is caused by high glucose levels damaging small blood vessels in the eyes, "the single most important way to help reduce the risk of vision loss from diabetic retinopathy and from diabetes is to optimize blood glucose control," says Abdhish Bhavsar, a Minneapolis-based ophthalmologist and a clinical correspondent for the American Academy of Ophthalmology.
A new study by researchers at the Joslin Diabetes Center, presented Sunday at the American Diabetes Association's annual meeting in Orlando, looks at people who have lived with type 1 diabetes relatively free of complications for 50 years or more. About 40 percent of the people in this group didn't have serious eye disease, which researchers think could be due to genes or other protective factors. Those who escaped serious eye problems also had "fairly good blood sugar control," says Jennifer Sun, lead study author and an ophthalmologist at the Joslin Diabetes Center, who says the findings emphasize the importance of proper blood sugar control, not just for eye health, but to prevent other complications of diabetes, too.
Keep blood pressure under control. Research suggests that the risk of diabetic retinopathy can be reduced by improving A1C levels—a measure of blood sugar over time—and by treating high blood pressure. Normal blood pressure is defined as less than 120 systolic (top number) over 80 diastolic; prehypertension ranges include 120 to 139 systolic over 80 to 89 diastolic; high blood pressure, or hypertension, includes readings of 140 and above systolic and 90 and above diastolic.
Get cholesterol levels checked. Some research suggests that improving cholesterol levels may slow the progress of diabetic retinopathy in those who have been diagnosed with the eye condition, leading experts to recommend that those with diabetes make this a priority—whether or not they've developed eye problems. The Fenofibrate Intervention for Event Lowering in Diabetes clinical trial showed that study participants with existing eye disease who took 200 milligrams of the cholesterol-lowering medication fenofibrate daily were less likely to need retinal laser therapy to treat their eye conditions, according to results published in 2007.
Exercise and maintain a healthy diet. Regular physical activity improves blood sugar control, as does a healthy diet, Bhavsar says. The U.S. Department of Health and Human Services recommends that adults get 150 minutes of moderate exercise per week and do strength training twice a week. Also, people newly diagnosed with diabetes are often told to eat a low-fat diet and watch their carbohydrate intake, but that doesn't mean they have to avoid foods they love. Instead, some flexibility is important, while keeping close tabs on blood sugar levels, experts say.
See an ophthalmologist annually. Often, an eye doctor can detect changes in the eyes well before a person notices problems with his or her vision. The AAO recommends that people with diabetes see an ophthalmologist when they're initially diagnosed with the disease and every year thereafter to head off problems.