Important Facts Every Diabetic Person Should Know

Diabetes is a disease which may remain quiet for many years and then suddenly, complications start and everything goes downhill.

If you are diabetic or have a relative with diabetes, you should know that the diabetic needs all the support and encouragement they can get to properly manage their condition.

Diabetes may be defined as a condition in which the blood sugar is abnormally high. This is often associated with high blood pressure and abnormal lipids (cholesterol). The combination of these three problems can lead to complications that can shorten your lifespan.Add smoking and drinking, slow suicide is the result.

Good control of diabetes, cholesterol and hypertension prevents complications. Complications such as those seen in the eye may be present at the time of diagnosis. In fact, if your vision becomes blurred, it could be due to undiagnosed diabetes.

A Glucometer is necessary for good blood sugar control. Having a Glucometer is like having a Doctor in your pocket. Uncontrolled high blood pressure and lipids (cholesterol) levels worsen the complications of diabetes. Controlling hypertension and lipids can reduce the complications of diabetes.

Testing your blood sugar level every morning CANNOT tell you that your diabetes is controlled. This can be VERY misleading as your overall sugar control may be very poor because your sugar level could be high throughout the day and into the night. You should check your sugar level at different times of the day, at least twice daily. These times include: two hours after each main meal and more often if necessary. If your two hour tests are too high, your meals are too large.

In the eyes, diabetes can cause serious damage to the retina. Sometimes, the sight may be good in the presence of the damage. If patients do not see the eye doctor immediately, blindness in two years may result.

Laboratory tests: Patients with diabetes should have laboratory blood tests performed at least twice yearly, preferably four times per year.

The tests requested by your Doctor should include the Glycosylated HbA1C otherwise called the A1C, serum lipids otherwise called cholesterol and renal function tests. This is now the recommended simple method to check your blood sugar control.

The A1C gives you an idea of your sugar control for the past 3 months. The A1C is usually less than 6.4% (NovoCard) in a non-diabetic person. In a diabetic person, greater than 8% is considered too high. If it goes above 10% for an extended period of time, eye, renal, cardiac and other serious complications WILL develop.

Always ask about these Laboratory tests, in fact, INSIST on these tests. Remember, a single finger prick at the office does not evaluate the control of your diabetes! Let the Doctor know that you are serious about your blood sugar control.

The treatment of diabetic eye disease is prevention. If complications are not dealt with in their early stages, ie, before the sight is affected, you could be in for a rough ride!

Diabetics should see their Ophthalmologist, NOT the Optometrist nor the Optician at least once per year and more often if there are complications.

Diabetes is the leading cause of blindness in the working population worldwide, approximately 1 in 10 persons is diabetic and Jamaica is no exception. Work closely with your Doctor to maintain good blood sugar and blood pressure control and lipids (cholesterol) at an acceptable level.

Laser treatment for diabetic eye disease does NOT cause blindness. It is the complications of diabetes that cause blindness. Most times, Laser treatment does not improve your sight overnight; it helps to slow down the progression of the complications. Late eye complications can be a nightmare for both the patient and the Ophthalmologist. The retina may be very severely damaged and in spite of repeated expensive surgical procedures, the amount of sight salvaged may be very minimal, and sadly sometimes none at all.

A recent development is the availability of injections to treat some of the eye complications of diabetes. These injections, namely Lucentis and Avastin, are available in Jamaica and when used in combination with laser treatment, can be quite beneficial to the patient. These injections are FDA approved. When properly administered these injections are painless and safe. The curious and the academic may Google Lucentis and Avastin for further information.


AUTHOR: Dr. Albert Lue, F.R.C.S.(Ed.)
DATE: October 7, 2015
GENRE: Ophthalmology, Biology, Medical Sciences