The International Diabetes Federation (IDF) estimated that 12.2% of the population between the ages of 20 and 19 in Malta had diabetes in 2019. This is one of the highest diabetes rates in Europe.
While most of the effects of diabetes on the kidneys, heart, and legs are well known, the effect on your eyes is a ticking time bomb that shouldn’t be ignored. In addition to greatly increasing the risk of cataracts and glaucoma, it also affects the blood vessels in your retina, the light-sensitive layer on the back of the eye that converts light into electrical signals that are then converted into images by the brain. These diabetic effects on the retina lead to a condition called diabetic retinopathy, which can potentially lead to vision loss and blindness. In fact, diabetes is the leading cause of vascular blindness worldwide and the leading cause of new blindness in people between the ages of 25 and 64 worldwide.
Over time, diabetes causes the blood vessels in your retina to narrow, leading to areas where there is not an adequate blood supply. This leads to a swelling of the retina, which, if it occurs in the center of the retina, the so-called macula, can lead to considerable loss of vision. The retina also tries to make up for this lack of oxygen and nutrients by creating new blood vessels. The problem is that these new vessels are fragile and easy to rupture, causing bleeding in the fundus, which can also lead to serious visual disturbances.
This may all seem very dramatic, but the crux of the matter is that Initially, these deleterious events go unnoticed as vision loss or other symptoms appear late in the disease process. If this diabetic damage goes unnoticed, it won’t manifest itself until it’s too late.
It is therefore important that diabetics be aware of the asymptomatic nature of this disease
As with many other conditions, prevention is better than cure, and good control of diabetes and other risk factors remains the cornerstone of diabetic retinopathy treatment. A healthy, balanced diet combined with regular exercise and adequate control of blood pressure and cholesterol is key to warding off these vision-threatening complications. Losing weight if you are overweight, smoking cessation, and moderating alcohol consumption to the recommended range will all help to improve overall health and reduce the risk of developing these complications.
The treatments available have limited effectiveness in advanced disease and are in fact not curative. However, they are important to prevent further vision loss and should not be delayed. The main treatment that can be offered when this diabetic retinopathy gets out of control is the laser. Lasers are used to treat the new, weak blood vessels to reduce bleeding and other disease complications. While laser doesn’t improve your eyesight, it does stabilize your retina and slow the progression of the disease. In addition to the laser, drug injections into the eye may also be offered to reduce the formation of these new blood vessels.
It is therefore important that diabetics are aware of the asymptomatic nature of this disease and attend eye clinics regularly to ensure early diagnosis and treatment. Regular visits to your family doctor to ensure good control of blood sugar, blood pressure and cholesterol also help combat this disease and reduce the looming vision-threatening crisis of diabetic retinopathy.