Diabetes

Its important to maintain good metabolic control in order to prevent or slow progression of retinopathy.  Good metabolic control is important to manage this early stage. Manage your blood glucose level and your blood pressure. Targets of HbA1c <7%, BP <130/80 mmHg (SMBP <125/75 mmHg) should be achieved to improve vision, prevent or slow progression of retinopathy. Lipid and kidney status should also be controlled. Let your doctor know if you are experiencing diminished vision or…

Treatment depends on the stage of Diabetic retinopathy  Early nonproliferative diabetic retinopathy (NPDR) Let your doctor know if you are experiencing diminished vision or any other eye problems like blurriness.  Retinal imaging (Fundus Fluorescein Angiography, Optical Coherence Tomography) followed by retinal laser treatment is indicated in this stage of retinopathy. Recently, Intravitreal injections (injections in the eye), which maybe Anti VEGF (Avastin, Lucentis) or steroid…

Stages of Diabetic Retinopathy are:  Early nonproliferative diabetic retinopathy (NPDR) This is the early stage when the patient is usually asymptomatic or has mild blurring of vision. On examination, the eye care provider may find the following when looking into the patient’s eye with an opthalmoscope: Microaneurysm (small, red dots often in a punctuate pattern) with or without swelling of the retina Dot and sparse blot haemorrhages (red, round or blot-shaped in the inner nuclear layer or…

Symptoms of Diabetic Retinopathy are: Blurring or haziness of vision Spots or lines in field of vision – Floaters Diminished vision, which may vary from mild decrease in reading vision (macular edema) to total loss of vision due to bleeding (vitreous haemorrhage).

Can it be prevented A holistic approach – controlling blood sugar, hypertension, dyslipemia  and kidney status with a good exercise routine -  is the best preventive measure. What kind of screening tests should I undergo? Here are some guidelines, according to American Diabetic Association Adults and children aged >10 years with Type 1 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist within 5 years of the onset of…

Are you at risk of developing diabetic retinopathy  Yes, if you have: Persistent hyperglycaemia (high blood sugar)  Diabetes of more than 5-years duration Albuminuria (too much protein in the urine>30mg in 24hours) Hypertension Dyslipemia

These measures can help you manage the progression of diabetic neuropathy: Keep your blood pressure under control. Having both high blood pressure and diabetes greatly increases your risk of complications because both damage your blood vessels and reduce blood flow. Try to keep your blood pressure in the range your doctor recommends. Make sure you check in regularly.  Make healthy food choices. Eat a balanced diet that includes a variety of healthy foods, especially fruits, vegetables and…

There's a lot you can do to prevent or delay nerve damage. And, if you already have diabetic neuropathy (nerve damage), these steps can prevent or delay further damage and may lessen your symptoms.  The most important thing is to keep blood sugar levels under control: Healthy planned diet, physical activity and medications, if prescribed, can help you reach your target range. Use a blood glucose meter to check your daily levels. Get an A1C test (a lab test) at least twice a year to find…

The symptoms and signs of diabetic neuropathy depend on the type of neuropathy present with varying severity.  1. Peripheral neuropathy  This presents with numbness or tingling, pain or burning sensations, loss of sensation in the feet or lower legs and sometimes in the hands or arms. This affects the peripheral nerves, most commonly the nerves of the feet and legs.  2. Proximal neuropathy  This presents with one-sided pain in the hips, weakness in the thigh muscles, weight…

The treatment is based on the types of diabetic neuropathy  1. Peripheral neuropathy treatment Manage pain with standard analgesics Maintain HbA1c below 7% Avoid tobacco and narcotics Localised pain can be managed with topical capsaicin, antidepressants (duloxetine, amitriptyline, imipramine, desipramine, venlafaxine), anticonvulsants (carbamazepine, gabapentin, phenytoin), or antiarrhythmic drug mexilitine (oral lidocaine). 2. Proximal neuropathy treatment Manage joint pain with…