How Does Diabetes Cause Eye Problems? What the Experts Say

World Diabetes Day takes place each November 14th to raise awareness about diabetes and promote disease prevention, treatment and care efforts. In 2007, the United Nations designated November 14 as World Diabetes Day, commemorating the birth of Lord Frederick Banting, the Canadian scientist who co-discovered insulin with Charles Best in 1922.

Diabetes is a disease that affects an estimated 537 million people worldwide, including over 77 million in India. It is also associated with various types of eye problems. On World Diabetes Day, we discuss the science and expert opinion behind these eye problems.

The science behind diabetes leading to eye problems

In people with diabetes, there is an accumulation of advanced glycation end-products, harmful products formed when proteins and fats combine with sugars in the bloodstream.These products damage the microvasculature of various organs. give Thus, the retinal microvasculature, including capillaries, is damaged by glycation end-products. When the small blood vessels in the eye are damaged, fluid leaks into the retina. This results in muscle edema leading to ischemic optic neuropathy and capillary death. Ischemic optic neuropathy is a condition in which blood does not flow properly to the optic nerve of the eye. When capillaries die, they suffer from ischemia and hypoxia, Dr. Natasha Radhakrishnan, a clinical professor of ophthalmology at Amrita Hospital in Kochi, told ABP Live in an email. Due to lack of blood supply, the cornea does not get enough oxygen.

Also read | World Diabetes Day 2022: How Diabetics Can Manage Eye Problems

Hypoxia results in the release of vasoactive endothelial growth factor (VEGF), a substance that promotes the growth of new blood vessels. Neovascularization occurs when blood vessels begin to form within the retina. This is the process by which new vascular structures are assembled. In iris neovascularization, there is abnormal blood vessel growth in the iris of the eye. All of these problems can occur if a diabetic does not take precautions.

Diabetics are also prone to cataracts. Cataracts are caused by hyperglycemia, which allows glucose to enter the lens. Dr. Radhakrishnan said this causes the eye fibers to become cloudy.

Diabetics can also develop glaucoma, a series of eye diseases that damage the optic nerve.

Dr. Saurabh Choudhary, CEO of ICARE Eye Hospital in Noida, said, “Diabetes mellitus is a complex metabolic disorder characterized by hyperglycemia, an abnormal physiological condition manifested by persistently elevated blood sugar levels. ” he told ABP Live.

“Hyperglycemia is a chronic disorder of carbohydrate, fat, and protein metabolism that results from abnormalities in insulin secretion or insulin action, or both, affecting multiple organs of the body and disrupting their normal function. Structural and functional disruption of the organ system vasculature leads to microvascular and macrovascular complications.Commonly affected body organs are the eyes, kidneys, and heart. , nerves,” added Dr. Choudhary.

Diabetic eye problems are associated with the duration of diabetes

Diabetic retinopathy is associated with a patient’s duration of diabetes, management of the condition, and risks such as nephropathy (decreased kidney function), anemia, hypertension, smoking, obesity, dyslipidemia (imbalance of lipids such as diabetes). It is directly related to factors. cholesterol, LDL, HDL, and triglycerides), among others. All of these risk factors contribute to diabetic retinopathy in people with diabetes, he says, Dr. Radhakrishnan.
Cataracts are primarily associated with hyperglycemic conditions in patients. The more uncontrolled sugar is, the more likely the lens is to develop cataracts compared to anything else.

Glaucoma, on the other hand, is multifactorial. Only some diabetics are more likely to develop glaucoma compared to others, Dr. Radhakrishnan said. more likely to suffer.

Diabetic patients can develop both diabetic retinopathy and cataracts, Dr. Radhakrishnan said.

Having diabetes at a young age increases your chances of developing cataracts by two to five times, Dr. Choudhry said.

Diabetes doubles the risk of open-angle glaucoma. Open-angle glaucoma is a condition where new blood vessels grow in the iris and block the normal flow of fluid from the eye. This increases the intraocular pressure. Pressure can damage the optic nerve, which carries signals from the eye to the brain, Dr. Choudhry added.

Risk factors for diabetic eye disease

More than half of people with diabetes can develop diabetic retinopathy, Dr. Choudhry said. Proper management of diabetes can reduce the risk of developing diabetic retinopathy. Women with diabetes who become pregnant or who develop gestational diabetes are at increased risk of developing diabetic retinopathy.

Poor blood sugar control, high blood pressure, high cholesterol, pregnancy, and smoking are risk factors for diabetic eye disease.

Diabetics should have a dilated eye exam every year to see if they have diabetic retinopathy, Dr. Radhakrishnan said. If you have type 2 diabetes, you should get your eyes screened as soon as you are diagnosed, as diabetes is likely to be detected late.

If your blood sugar is uncontrolled and you suffer from ketoacidosis (a diabetic complication in which acid builds up in your blood), you may be suffering from other complications such as eye and sinus infections. Yes, it can spread to the eye.

The longer you have diabetes, the more likely you are to suffer from eye problems.

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