One of the more common complications of diabetes is retinopathy. The retina is composed of a layer of nerves located at the back of your eye – it’s what takes “pictures” and sends the images to your brain. In people with diabetes, nerve damage to the retina can occur when blood glucose levels remain high over a long period of time.
Four steps you can take to prevent or delay diabetic retinopathy.
1. The most important thing you can do to protect your eyesight is ensure that your blood glucose levels are in the target range. The Diabetes Control and Complications Trial, a large study conducted in the 1990s, found that lowering blood glucose levels into the target range – and keeping them there – reduced the risk of eye disease by a whopping 76%.
According to the Diabetes Canada's 2018 clinical practice guidelines, the recommended blood glucose targets for people with diabetes are as follows:
|A1C (%)||Blood glucose before meals (mmol/L)||Blood glucose two hours after a meal (mmol/L)|
|Target for most people with diabetes||7.0 or less||4.0 to 7.0 (4.0 to 5.5* if A1C targets are not being met)||5.0 to 10.0 (5.0 to 8.0* if A1C targets are not being met)|
- Balance against risk of hypoglycemia
2. Have your eyes tested at regular intervals. According to the clinical practice guidelines:
- People with type 2 diabetes should be screened for retinopathy at the time that they’re diagnosed.
- Women with diabetes or women who hope to become pregnant should be screened before conception, during the first trimester, as needed during pregnancy and within the first year after giving birth.
- The timing of follow-up assessments should be tailored to the severity of the retinopathy. In people with no or minimal retinopathy, the recommended interval for re-screening is every one to two years.
3. Blood pressure and cholesterol are other factors that affect retinopathy – having high blood pressure or high cholesterol levels can make eye problems worse. If your doctor has given you any medications for blood pressure or cholesterol, be sure to take them as prescribed. The targets for people with diabetes are as follows:
- Blood pressure less than 130/80 mmHg
- Low-density lipoprotein cholesterol less than or equal to 2.0 mmol/L.
4. If you smoke, quit smoking. A number of studies have shown that smoking can actually make retinopathy worse. Click here for tips and strategies to help you kick the habit.
How will I know if I have retinopathy?
See an eye care professional (either an optometrist or an ophthalmologist) if you notice any of the following symptoms of retinopathy:
- blurred vision
- flashes of light in your field of vision
- sudden loss of vision
- blotches or spots in vision
Remember, though, in the early stages of retinopathy some people don’t experience any symptoms at all. That’s why it is important that you have regular eye examinations.