Manage Blood Glucose Levels to Decrease Risk of Retinopathy
Retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. Although non-diabetics can develop retinopathy, those with higher blood glucose levels get the disease more often and usually in a more severe form. As February is “Save Your Vision Month”, the American Academy of Ophthalmology is urging all to take steps to preserve their eyesight.
Poorly Controlled Blood Sugar Leads to Vascular Complications
High blood glucose levels are associated with microvascular complications. Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. Also, fluid can lead into the center of the macula, causing it to swell. In addition to retinopathy, those with diabetes are at a greater risk of developing cataract or glaucoma.
Pascale Massin MD PhD of Hopital Lariboisiere in Paris and colleagues examined the retinas of 700 men and women, average age 52, which were enrolled in an epidemiological study of insulin resistance syndrome. Over the preceding nine years, the participants had their fasting plasma glucose levels and hemoglobin A1C tracked. During that time 235 had been diagnosed as diabetic, 227 had impaired fasting glucose levels, and 238 had blood glucose within normal limits.
A total of 44 of the participants were classified as having retinopathy – 38 of which had higher than normal glucose levels 10 years prior.
The authors propose that physicians use a fasting glucose level of 108 mg/dL and HbA1c of 6.0 or higher to define those who are at a greater risk for retinopathy. The lowering of the standard would include not only diagnosed diabetics, but also those who have prediabetes, a condition of higher than normal blood glucose that usually precedes Type 2 diabetes.
All Americans are encouraged to take control of their blood glucose levels to prevent complications such as diabetic eye disease. Proper diet, exercise, and medications can maintain blood sugar levels into a more normal range.
One diet component that may help prevent retinopathy is omega-3 fatty acids. Researchers at Children’s Hospital in Boston found several years ago that mice fed a diet rich in omega-3’s had nearly 50% less pathologic (abnormal) vessel growth in the retina and has a direct effect on the growth of healthy blood vessels. The nutrients also appeared to decrease inflammatory messaging in the eye.
Omega-3 fatty acids can be found in fish such as salmon, tuna, and halibut and some plants and nut oils. The American Heart Association recommends eating fish at least 2 times a week.
In addition to encouraging good lifestyle habits, the AAO encourages all Americans, especially those over the age of 40, to make an appointment for an eye examination. By 2020, 43 million Americans will be at risk for significant vision loss or blindness from age-related eye diseases, an increase of more than 50% over the current number.
“Eye diseases become more common as we age, but eye problems can occur at any age. Getting a comprehensive eye exam, and following through with the recommendations of [an ophthalmologist] can be the difference in saving your vision or preventing further vision loss later in life,” said Aaron Weingeist, MD, an ophthalmologist in Seattle and a clinical correspondent for AAO.
Archives of Opthalmology 2011;129:188-195.
Science Translational Medicine, Feb 9, 2011