Diabetic retinopathy is a potentially blinding complication of diabetes that damages the eye's retina. It effects half of all Americans diagnosed with diabetes.
However, only 6% of diabetics lose their vision. Blindness is largely preventable if patient and the medical team work together diligently. Prevention relies upon the proper use of medications, daily blood sugar testing, correct lifestyle habits, diet and supplementation.
Complications related to sugar/glucose imbalances in the blood can result in damage to the retina which may not be noticeable at first, but the consequences can get worse with time severely threatening vision.
Next: Nutrition, vitamins, diet, & lifestyle for diabetic retinopathy.
It is possible to have diabetic retinopathy for a long time before you realize it. In many cases, the symptoms of diabetic retinopathy are not apparent until the retina has been quite damaged and your sight has been compromised.
Symptoms of diabetic retinopathy and its complications may include:
- Blurry or distorted vision
- Difficulty reading and other close work
- Increased number of eye floaters
- Partial or total vision loss or what feels like a permanent shadow cast across your field of vision
- Eye pain
Causes of Diabetic Retinopathy
- The blood/ocular barrier layer of the retina is a compound structure in the eye that prevents large particles in large capillaries from entering the retina. The retinal pigmented layer is responsible for the outer layer of this barrier and diabetic retinopathy incidence is related to its breakdown. 11
- Photoreceptor cell death/damage may play a central role in deterioration of microcapillaries in the eye that leads to diabetic retinpathy. Their deterioration is another hallmark of development of the condition.12 Researchers now report that oxidative stress spreads from damaged photoreceptor cells.13
- Diabetes & Pre-diabetes
- Type I Diabetes (Juvenile Diabetes) develops when the pancreas produces too little insulin. This condition generally starts in childhood.
- Type II Diabetes (Adult-Onset Diabetes) develop over many years, and is caused by the pancreas either not producing enough insulin or not being able to utilize the insulin produced effectively. In one study ore than 19% of patients with adult onset diabetes had diabetic retinopathy.10
- Low insulin sensitivity: enough insulin is present, but the physiology doesn't respond adequately.
- Nearly 8% of pre-diabetics have diabetic retinopathy. Pre-diabetics are defined as blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. It's also known as "impaired fasting glucose" or impaired glucose tolerance.10
- Poor diet high in refined carbohydrates and sugar, low in whole foods and antioxidants
- Lack of regular exercise
- Low serum magnesium in diabetic patients is a risk factor for diabetic retinopathy. 5
- Low folic acid levels are tied to greater risk of diabetic retinopathy.1
- Patients with kidney disease are at a greater risk of developing diabetic eye disease.2
- Vitamin D deficiency is associated with diabetic eye disease, like folic acid deficiency, the greater the deficiency the greater the risk and severity.3
- Lab animals treated with an extract of a tropical plant, Caesalpinia pulcherrima displayed better antioxidant levels and lessening of levels of blood sugar alcohol.4
- Depression has been tied to an increased risk of developing diabetes.6
- Inflammation has been associated with an increased risk of developing diabetes; furthermore, insulin treatment does not alleviate inflammation, as well as the integrity of capillaries and nerve functioning in the retina.7, 8
- Lack of oxygen to the retina has been reported as a cause of diabetic macular edema. In a small pilot study while patients were given supplemental oxygen therapy the condition improved. When such supplemental oxygen ceased the condition continued to worsen.9
Stages of Diabetic Retinopathy
NIH defines four stages of diabetic retinopathy:
- Mild nonproliferative form in which tiny capillaries experience swelling and leaking. These are called "microaneurysms."
- Moderate nonproliferative form in which some of these capillaries are completely occluded depriving the retina of nourishment.
- Severe nonproliferative form in which many capillaries are blocked and more of the retina does not receive needed nutrients. This triggers the body to grow new blood vessels to supply the deficit.
- Proliferative form is an advanced stage of diabetic retinopathy. New, fragile capillaries grow both within and along the surface of the retina and into the vitreous of the eye. The additional growth may not cause vision loss by itself, although portions of the retina can be distorted, in turn distorting vision. Because the new capillaries are thin-walled and fragile, they are at great risk of leaking.
Diabetic Retinopathy News
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Research and information
See these studies on diabetic retinopathy treatment.
1. G. Malaguarnera, et al, Folate status in type 2 diabetic patients with and without retinopathy, Clinical Ophthalmology, August, 2015.
2. H.P. Hammes, et al, Risk Factors for Retinopathy and DME in Type 2 Diabetes-Results from the German/Austrian DPV Database, PLoS One, July 2015
3. N. Alcubierre, et al, Vitamin D Deficiency Is Associated with the Presence and Severity of Diabetic Retinopathy in Type 2 Diabetes Mellitus, Journal of Diabetes Research, May, 2015.
4. M.P. Kumar, et al, The inhibitory effect of Isoflavones isolated from Caesalpinia pulcherrima on aldose reductase in STZ induced diabetic rats, Chemico-Biological Interactions, July, 2015
5. Studies on Magnesium and Diabetic Retinopathy
6. W. Kanton, MD, Medical News Today, July 29, 2011
7. PCON Supersite, March, 2010
8. G. Bixler, Chronic insulin treatment of diabetes does not fully normalize alterations in the retinal transcriptome, MBC Medical Genomics, May, 2011.
9. Q. D. Nquyen, et al, Supplemental oxygen improves diabetic macular edema: a pilot study, Investigative Ophthalmology & Visual Science, February, 2004
10. H. X. Zhang, et al, Prevalence of and risk factors associated with diabetic retinopathy in pre-diabetic and diabetic population in Shanghai community, Zhonghua Yi Xue Za Zhi. July, 2009.
11. J. Cunha-Vaz, R. Bernardes, et al, Blood-Retinal Barrier, European Journal of Ophthalmology, 2011
12. T.S. Kern, B.A. Berkowitz, Photoreceptors in Diabetic Retinopathy, Journal of Diabetes Investigation, July, 2015.
13. Y. Du, A. Veenstra, et al, Photoreceptor cells are major contributors to diabetes-induced oxidative stress and local inflammation in the retina, Proceedings of National Academy of Sciences (PNAS), August, 2013.