Diabetes and eye disease: causes and precautions

Published: 3 February 2015 at 15:21

Diabetes is a major public health concern, and its prevalence is increasing in the world. India has one of the highest numbers of people with diabetes in the world, and this is therefore a major concern. In the UK, the prevalence of diabetes is six times higher than in the South Asians compared to the Caucasians.

Diabetes is broadly classified as Type 1 and Type 2. Type 1 diabetes is less common, contributing to about 10% of all diabetes, and has an early onset. Type 2 diabetes is more common contributing to about 90% of all diabetes, and has a late onset (usually after the age of 40 years). In India, nearly 1 in 5 people living in urban (cities) and 1 in 10 people living in rural areas (villages) have Type 2 diabetes.

Diabetes is associated with various complications including problems in the heart, kidneys, feet and eyes. The most common eye problem associated with diabetes is the diabetic retinopathy. In diabetic retinopathy, the network of blood vessels supplying to the back of the eye (retina) is damaged. In very serious cases, blindness may result. Other eye diseases linked to diabetes are early cataracts (cloudiness in the lens). People with diabetes are 40% more likely to suffer from glaucoma (another potential sight-threatening eye condition) than people without diabetes.

A number of factors increase the risk of developing diabetic eye diseases, including the following.
Age: older patients are at a greater risk. However, patients who are already on insulin treatment (type I) can be at a greater risk even when they are younger.
Duration of diabetes: the longer the duration of diabetes, the greater the risk of developing diabetic eye disease.
Type of diabetes: patients with Type 1 diabetes are at an increased risk of developing diabetic eye disease.
Complications in other organs: the risk of developing diabetic eye disease will increase if other parts of the body (such as kidney) have been already affected by diabetes.

It is likely that poorly controlled diabetes will lead to the blindness. It is therefore vital to make sure your diabetes is well controlled. A study led by Professor Shahina Pardhan from the Vision and Eye Research Unit (VERU) in the UK showed that there were key lifestyle and knowledge awareness differences that existed in different ethnic groups. The study identified a clear need to: (i) improve patient engagement in self-management of the disease, (ii) provide better education to improve lifestyle choices, and (iii) ensure attendance at regular eye checkups.
Here are some useful tips for diabetic patients.
• Increase your awareness about diabetes: Read about your diabetes and understand why good control is essential to reduce diabetic complications including eye diseases.
• Make sure you have regular eye checkups. There are various stages of changes in the eye before severe complications of diabetes occur. If these changes are caught early, through regular eye checkups, then early treatment can prevent blindness.
• Do regular exercise: It is important that you exercise regularly. There are various exercises that may suit you. For example some gyms offer keep-fit exercises to Indian music. You may also consider doing brisk -walking, or forming a 'garba group'.
• Your food: Be careful of food you eat. It is not just sugar that you have to worry about. Eat less fat and increase your uptake of fresh fruits and vegetables. Avoid ghee and butter on your roti and curries. Make sure that you try to control your intake of rich oily and sweet food at weddings, or when breaking your religious fast.
• Support: Get support from your family. Join or start up a diabetes self-help group.
To summarise,  regular eye check-ups, improved diet, regular physical exercise and adequate self-awareness about diabetes are all very important to control diabetic eye diseases, to reduce the risk of blindness and to improve quality of life.

Professor Shahina Pardhan and Professor Rajiv Raman
Vision and Eye Research Unit (VERU), Anglia Ruskin University, UK
SankaraNethralaya Hospital, Chennai, India

Professor Pardhan, in collaboration with Professor Rajiv Raman, has recently set up an international collaborative research group with researchers from various parts of India working towards reducing the risk of diabetic eye disease.