Metabolic Control in Diabetic Retinopathy – Take Care of Your Health

New Delhi. Eye problems are a common side effect of aging, but, if you are suffering from diabetes, it can be considered a sign of other problems as well. One of the lesser known complications of diabetes is diabetic retinopathy (DR). This is a possible cause of all retinal disorders that result from diabetes. Ignoring DR, eyesight can go away forever.

Diabetic retinopathy is difficult to diagnose, as many of the symptoms associated with it feel like an aging-related disorder. However, people with diabetes show specific symptoms and should be taken into account by the caregivers of people suffering from it. If you or your loved ones feel this type of disorder, do not delay in seeing a doctor1.

Once your DR is diagnosed, you can take necessary steps to prevent the disease from progressing. If we talk about the whole body, then there are many systems that affect each other. For example, if there is some problem with your kidney, then your retina is also affected, even if you do not see the connection between them. Years of research on DR has revealed many links between high blood pressure, high cholesterol, kidney disease caused by diabetes, high blood sugar, vitamin and mineral deficiencies, exercise2 and the progression of the disease.

control sugar fluctuations
The fluctuations in sugar are controlled in the same way as a person with diabetes. The good news is that it helps reduce the risk of DR aggravating and its growth rate. A 1% reduction in HbA1c, a 35% reduction in the risk of developing DR, a 15-25% reduction in the progression of the disease, a 25% reduction in vision acuity loss and a 15% reduction in the progression of blindness3 may come.

The NHS UK recommends checking the sugar level several times a day, as levels can vary. If you check your blood sugar level at home, it should be between 4 and 7 mmol/l. As a person with diabetes, your HbA1c or average blood sugar level should be around 6.54% or 48 mmol/mol.

controlling blood pressure
If you have diabetes, the NHS recommends that your blood pressure readings should not exceed 140/80mmHg. If you have diabetic complications (such as eye damage4), this reading should be less than 130/80mmHg. Based on a comparison of patients with a BP of 180/100 mmHg and patients with a BP of 150/85 mmHg, the second group 3 (with 150/85 mmHg) had a 33% reduction in the rate of progression of DR and a 50% reduction in vision loss. A decrease was observed.

controlling lipids in the bloodstream
When we speak of ‘lipids’, they generally include levels of cholesterol, lipoproteins, chylomicrons, VLDL, LDL3, apolipoproteins and HDL3. According to the NHS, a healthy person should have a total cholesterol level of less than 4 mmol/l4.

Elevated serum lipid levels are associated with a specific risk of DR complication. This is called ‘hard exudates’. Reducing high serum lipid levels may reduce the risk of hard exudates in people with diabetic retinopathy5. Therefore, when the serum lipid levels are high, you can bring about a change in your vision by taking appropriate action.

Obesity, physical activity and DR
Everyone knows that obesity and diabetes can go hand in hand. Now, even science supports it. A meta analysis on people with type 2 diabetes showed that obesity increases DR3.

The good news is that increasing physical activity reduces the risk of developing DR! High levels of physical activity not only reduce DR in people with type 2 diabetes, but 30 minutes of physical activity per week for just five days can reduce the risk of developing DR by 40%.

Diet and foods that help treat DR
There are many options available for those who want to fight DR by changing their diet. While we all try to get a good mix of fruits, vegetables, dairy, grains and other food groups, there are foods that are more effective in fighting DR and other chronic diseases, in addition to certain diets. Has happened.

  • According to one study, a Mediterranean diet containing extra virgin olive oil or nuts (almonds, etc.) combined with a low-fat diet can reduce the risk of retinopathy by more than 40%!
  • By consuming oily fish at least twice a week, the risk of retinopathy can be reduced by about 60%.
  • Many vegetables, fruits and seeds contain minerals, polyphenols and other phytochemicals, which reduce oxidative stress, inflammation and resistance to insulin. In fact, a higher intake of flavonoid-rich fruits and vegetables is associated with a lower risk of diabetic retinopathy.

Vitamin and mineral deficiency
We all try to eat well. Between the daily stress of cooking and ordering, the quality of the food product available in our cities and our likes and dislikes towards certain types of food, our bodies may be deficient in vitamins and minerals. Regular blood tests and doctor’s advice can help to overcome these deficiencies. With this, not only can the loss of eyesight be prevented, but many other organ systems of the body can also be protected.

Vitamin B1 (Thiamine): High doses (50-100 mg/day) of thiamine supplementation are safe and useful for the treatment and recovery of neuroprotection, DR, diabetic nephropathy and affected-limb injury.

vitamin D: Maintaining a standard level of vitamin D in the body plays an important role in reducing the risk and severity of DR. Not only this, it also helps in the treatment of atherosclerosis, heart disease, type 2 diabetes and high blood pressure apart from helping the pancreas to function properly.

Vitamin E: In a 10-year study in people with type 1 diabetes, a daily dose of 1800 IU of vitamin E supplemented with improved blood flow to the retina. It also reduces the increased oxidative stress caused by DR.

Zinc: Zinc deficiency is associated with the progression of chronic diseases. For example, metabolic syndrome, diabetes, microvascular complications associated with diabetes and DR.

The most effective defense against vision loss: Regular tests
The first step towards achieving better health begins with an accurate diagnosis, especially when it comes to diabetes and DR. Diabetes often causes a number of complications that have nothing to do with insulin or high blood sugar levels. This is because diabetes affects the functioning of many organ systems in the body. Therefore, the first step in taking appropriate action, is to understand what is wrong.

Its symptoms are caught only after the progression of the disease of DR, so it is important to get advance and regular check-ups for DR. The overall prevalence of DR among people with diabetes was estimated to be 35%, estimated through retinal images, based on an analysis of 35 studies conducted around the world between 1980 and 2008. Of this, 12.66 percent was of DR with eyesight risk. In India, the number of people living with diabetes is expected to increase to 134 million by 20457. If this happens, DR will become a significant challenge to public health.

However, once DR is detected, you and your doctor can work out a better course of treatment. Also, health can be managed and further damage to eyesight can be avoided. Awareness and regular testing is essential to detect DR.

Keeping the above in mind, in the year 2021, Network18 in association with Novartis launched ‘Eye Suraksha’ – India Against Diabetes initiative. In the first season, the initiative brought together the best experts from medicine, policy making and think tanks to raise awareness about DR. This year, this initiative is going to do a great job by organizing individual health camps across the country.

eye protection website (https://www.news18.com/netrasuraksha/) However, the content of season 1 knowledge articles, explainer videos and panel discussions can be seen. Also, the latest information can also be obtained about when and where the health camps are being organized. Be our partner to spread your word and increase your knowledge to others with diabetes.

Remember, blindness caused by DR can be prevented in time. In order to keep yourself healthy, make changes in your diet, exercise methods and lifestyle with the advice of a doctor. The one who runs slow and non-stop wins the race!

References:

Diabetic Retinopathy. Available [online] at URL: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy. Accessed on August 3rd 2022.
Saini DC, Kochar A, Poonia R. Clinical correlation of diabetic retinopathy with nephropathy and neuropathy. Indian J Ophthalmol 2021;69:3364-8.
Bryl A, Mrugacz M, Falkowski M, Zorena K. The Effect of Diet and Lifestyle on the Course of Diabetic Retinopathy-A Review of the Literature. Nutrients. 2022 Mar 16;14(6):1252.
Diabetic Retinopathy Prevention. Available [online] at URL: https://www.nhs.uk/conditions/diabetic-retinopathy/prevention/. Accessed on August 3rd 2022.
Chew EY, Klein ML, Ferris FL, et al. Association of Elevated Serum Lipid Levels With Retinal Hard Exudate in Diabetic Retinopathy: Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22. Arch Ophthalmol.1996;114(9):1079–1084.
Yau JW, et al. Meta-Analysis for Eye Disease (META-EYE) Study Group. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012 Mar;35(3):556-64.
Nanditha A, et al. Secular TRends in DiabEtes in India (STRiDE–I): Change in Prevalence in 10 Years Among Urban and Rural Populations in Tamil Nadu.Diabetes Care 2019;42:476–485

Tags: Diabetes, Health

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