This World Diabetes Day today, we connect with a few diabetologists and endocrinologists, bringing to you a detailed analysis of diabetic retinopathy, a complication of diabetes that affects the eyes.
Shikha Duggal
Did you know that diabetes can also damage your eyes over time, which can lead to vision loss or even blindness? Yes, many of us confuse diabetes with just insulin resistance. Today, on World Diabetes Day, The Daily Pioneer Hyderabad speaks with doctors from a few of the city’s most popular hospitals about how to manage diabetes while also preventing and treating vision problems.
Dr. Dilip Gude, senior consultant physician at Yashoda Hospitals, informs, “Persistently uncontrolled sugars cause damage to the layer behind the eyeball that is your retina. This results in loss of the transmissive ability of visual input from the eye to the brain, which eventually results in blindness!”
He’s referring to this phenomenon as diabetic retinopathy. This sounds new to us too, but he clarifies, “Although retinopathy can be treated and reversed to some degree with tight glucose and BP control, the later stages, such as proliferative diabetic retinopathy, may cause permanent blindness! Intravitreal bevacizumab and laser photocoagulation help minimise the damage of proliferative retinopathy. In the mild stage, microaneurysms, which are tiny pockets of swelling, form in the blood vessels of the retina. In the next moderate stage, there is increased swelling of the blood vessels, eventually causing a leakage of blood and fluid into the retina and causing interference with vision. In the later, severe non-proliferative stage, with persistent, uncontrolled blood sugar, larger areas of blood vessels leading to the retina begin to experience blockages as well as continued bleeding.”
He further shares, “Vision is usually seriously impacted at this stage! The last and most severe stage, which is proliferative diabetic retinopathy, occurs when the retina tries to compensate for the severe damage by a process called angiogenesis and nonproliferation. This may result in partial or full blindness.”
During our further research, we found out that there is a platform named Twin Health. This is a precision health platform that integrates sensors, machine learning, and medical science and recently announced its breakthrough technology in relation to diabetes.
The scientific outcomes of the technology are from a randomised clinical trial and have been validated by acceptance in scientific sessions held by the American Diabetes Association and many other organisations for the remission of Type 2 diabetes and other chronic metabolic diseases such as obesity, hypertension, and non-alcoholic fatty liver disease.
Remission in Type 2 diabetes is defined as maintaining normal blood glucose levels for at least three months without the use of diabetes medication! Their AI-powered research has reported the highest known remission rate for type 2 diabetes. Awareness is so needed for us to be aware of this common disease, which is laying out its dangerous branches in many ways in our bodies. We found an ayurvedic angle to it too.
Dr. A.K. Gadpayle, the medical superintendent at Sharda Hospital, shares, “8.5% of adults aged 18 years and older have diabetes mostly. In India, currently, 25.2 million adults are estimated to have IGT, which is estimated to increase to 35.7 million in the year 2045. India ranks second after China in the global diabetes epidemic!
Diabetes is even known to be the direct cause of 1.5 million deaths, and 48% of all deaths due to diabetes occurred before the age of 70. Another 4,60,000 deaths from kidney disease were caused by diabetes, and raised blood glucose causes around 20% of cardiovascular deaths. Eye diseases that can affect people with diabetes include diabetic retinopathy, macular edema, cataracts, and glaucoma. All can lead to vision loss, but early diagnosis and treatment can go a long way toward protecting your eyesight! Anyone with Type 1, Type 2, or gestational diabetes can develop diabetic retinopathy. The longer the duration of diabetes, the more likely it is to develop. Symptoms in the advanced stage can include blurry vision, spots in your vision, trouble seeing colours, and dark or empty areas in your vision.”
As for the treatment, he says, “Treatment can start before your sight is affected, which helps prevent vision loss. Options include laser therapy. This creates a barrier of scar tissue that slows the growth of new blood vessels. Medicines called VEGF inhibitors can slow down or reverse diabetic retinopathy. Removing all or part of the vitreous! Reattachment of the retina and retinal detachment are complications of diabetic retinopathy. Lastly, the injection of medicines called corticosteroids. In the Ayurvedic language, diabetes happens when there are blockages caused by the aggravation of Kapha. The other reason is the depletion of tissues in the body. The latter is called Dhatukshaya! Immunity drops when there is an accumulation of toxins called ama in the body due to poor digestion, which is related to diabetes. Weak immunity amplifies the symptoms of the ailment.”
Dr. Abhishek Hoshing, consultant in ophthalmology at Apollo Hospitals, continues, “Most importantly, one has to keep blood sugar under very strict control. Coexisting conditions such as high blood pressure, as well as serum lipid levels, should be well managed. Patients should maintain a healthy lifestyle with appropriate exercise and diet. Diabetic patients should have a comprehensive eye exam once a year at first, then every 6 months if advised to detect early retinopathy changes. Appropriate treatment, if any, as advised by the ophthalmologist should also be strictly followed to avoid severe and irreversible vision loss.”
According to the healthcare company, young Indians in the age group of 25–34 recorded the highest spike in consultations, as their share of consultations increased by 46 per cent since last year. Doctors suggest poor lifestyle choices, a lack of exercise, or even poor dietary habits might be some of the factors contributing to the rise in diabetes among young Indians, so we must change this.
