Diabetes mellitus is a common endocrine disorder that may not sound like it has much to do with the eyes, but it does not. Direct acute complications caused by diabetes are not common in clinical practice, such as ketoacidosis and hyperosmolar coma. The greatest danger of diabetes is that it can cause many chronic complications, and ocular pathology is one of the most common chronic complications of diabetes.
The danger is serious
Two studies that have received a lot of attention in the last century: After the 1980s, two studies on diabetes that have been praised by numerous doctors around the world are the “Diabetes Control and Complications” (DCCT) by the expert team of Harvard scholar David Nathan and the “Prospective Diabetes Study” by the expert team of Oxford scholar Robert Turner. These are the Diabetes Control and Complications (DCCT) by the expert team of Harvard scholar David Nathan and the Prospective Diabetes Study (UKPDS) by the expert team of Oxford scholar Robert Turner. They used higher frequency monitoring and interventions to delay the complication rate of the original brash glucose-lowering efforts. However, there appear to be “uncommon” differences between the two studies. For example, in controlling the incidence of retinopathy, the Harvard group delayed it by 76%, while the Oxford group delayed it by 21%. In fact, this difference is due to the fact that (1) the DCCT study group was dealing with a population of patients who were more prone to eye disease and thus could see this more pronounced delaying effect, but not the avoidance of eye disease; and (2) both treatment and control groups in both studies had access to insulin: the control group were patients whose disease was difficult to control, and the treatment group were patients who were relatively stable after insulin use.
These two experiments suggest that the threat of eye disease is far from lifted.
Common diabetic eye diseases
Almost all eye diseases can occur in diabetic patients. For example, fundus hemangioma, fundus hemorrhage, lacrimal sacculitis, glaucoma, cataract, vitreous turbidity, optic nerve atrophy, macular degeneration, and retinal detachment. Moreover, diabetic patients are significantly more likely to develop these eye diseases than the non-diabetic population.
All of these eye diseases are initially microangiopathies and therefore pose a problem for clinical treatment. The most popular approach to controlling blood glucose is insulin therapy. However, insulin damage to microvasculature is valued by many experts. Nevertheless, clinical experts more often advise patients to use insulin, and even publish articles proving that such harm does not occur when insulin is used properly.
These conditions suggest that diabetic eye disease has been plaguing the medical community.
Diabetic retinopathy
Diabetic retinopathy is a major blinding disease, yet most people with diabetes can escape the risk of blindness if it is detected in time and treated with standard care.
”Early treatment of diabetic retinopathy is satisfactory, but it can be difficult for patients to detect themselves because of the insidious onset of the disease. Compared to the one-to-one treatment model in the operating room, early intervention in the community is a one-to-million or more, but community medicine works well.” Community physicians can categorize the files of diabetic patients in the community, identify those who have developed fundus lesions and those who are at high risk for developing them, and give them regular lectures on how to control their diet and increase their exercise. During the community education, ophthalmologists and internists can be invited to go with the patients, and those who have already developed lesions can be given treatment plans according to the degree of their lesions, which is particularly effective.
Medical statistics show that 27.3% of diabetic patients develop fundus complications, and the incidence of diabetic retinopathy, which is a serious threat to vision, is between 6% and 13%. Once again, it is important to remember that community health care is essential for early intervention in diabetes. But what can be done with the medical conditions available in the community? The first step is to train and popularize the most basic prevention and treatment skills for physicians, such as the use of fundoscopy. “The graded approach to diagnosing diabetic eye disease is now well defined, and community physicians can usually detect the beginnings of a patient’s pathology early with as little as three weeks of specialized training.”
Diabetic retinopathy prevention
1.After confirming that they have diabetes, all patients should visit an ophthalmologist for an examination.
2.Control blood sugar with reasonable medication.
3.Increase the amount of exercise.
4.Ophthalmology follow-up regularly. In the early stage, medication can be applied to slow down its development, if it develops to a certain stage, laser treatment is needed, if it develops to an advanced stage, then surgery is needed.
Diabetic eye disease prevention
Early treatment of diabetic retinopathy is more effective. Because of the irreversibility of the lesion damage, prevention is the most important part, and the cost of early prevention is much lower than the cost of late surgical treatment, and the efficacy is also better.
1. Regular eye examinations to detect changes in visual acuity
It is recommended that diabetic patients should have their eyes examined annually with dilated pupils. type 1 diabetic patients should have their eyes examined regularly after puberty, and type 2 diabetic patients should have their eyes examined once a year or as prescribed by the doctor 5 years after the onset of the disease. If you have abnormal eye sensation, go to the ophthalmologist for examination and treatment in time, and to shorten the follow-up time of ophthalmology, such as once every six months or three months.
2. Early treatment
If you already have eye complications, follow the doctor’s advice, take medication on time and make necessary examinations, such as fundus fluorescence angiography.
If laser treatment is needed, be sure to follow the doctor’s instructions. For non-proliferative diabetic retinopathy, local laser treatment is available. If it is already a proliferative retinopathy, total retinal photocoagulation is required to prevent serious complications such as fundus hemorrhage and neovascular glaucoma. When the fundus hemorrhage is not absorbed and vitrectomy is needed, you should be determined to listen to the doctor.
3.Control blood sugar, blood pressure and blood lipid
Actively treat diabetes so that blood sugar can be satisfactorily controlled. At the same time, blood pressure should be strictly controlled, blood lipids should be lowered, and diet should be adjusted to eat more protein foods and less fat-containing foods to delay the appearance of diabetic retinopathy as much as possible.
Dietary treatment of diabetic eye disease
1, limit the amount of staple foods, but not excessively, so as not to cause hunger state ;
2.Eat less and more meals;
3, avoid eating all kinds of sugar and sweet food;
4, eat more leafy vegetables, eat more crude fiber, low-fat diet;
5, limit the consumption of fats, animal fats and cholesterol more food;
6, prohibit the consumption of alcohol, especially strong alcohol;
7, wolfberry, yam, shepherd’s purse can be decocted as tea, often taken, can lower blood sugar, also has the effect of lowering blood pressure.
Diabetes is generally a chronic disease, food therapy should be persistent, can not relax. If the progress of the disease cannot be controlled by food therapy combined with medication, insulin injections can be carried out under the close observation of the doctor. Once the systemic diabetes is controlled, the eye lesions should gradually stop progressing and the bleeding will be gradually absorbed.