Preventing Diabetic Retinopathy in Youth

Highlights:

A US study suggests that actively regulating blood sugar and blood pressure can prevent diabetic retinopathy in young diabetics
Diabetic retinopathy is a common eye disorder among young diabetics, affecting both Type 1 and Type 2 diabetes patients
Early detection and regular eye exams are crucial for preventing diabetic retinopathy and other diabetic eye complications

If you were diagnosed with diabetes at a young age, your blood sugar levels might damage your retina over time (). A new US study, however, claims that this ailment, known as diabetic retinopathy, can be avoided in people with juvenile diabetes if they actively regulate their blood sugar and blood pressure levels.

According to the study, which was published in the journal Diabetes Care by the American Diabetes Association, diabetes retinopathy is common in young people with diabetes, with 52% of those with Type 1 diabetes and 56% of those with Type 2 diabetes exhibiting retinal abnormalities at follow-up ().

However, experts in India say that the general public is unaware of diabetic retinopathy. "Be aware of your fasting, postprandial, and HbA1c numbers. If you have diabetes, you should receive a baseline retinal picture and an annual check-up. Start early with lifestyle management, such as physical activity and a well-balanced diet, to prevent diabetes and its complications," says Dr. S Natarajan, president of the Asia Pacific Ophthalmic Trauma Society.

Diabetic Retinopathy
The term ‘diabetic retinopathy’ refers to changes in the retina which often occur in people with diabetes.

‘Protecting Young Diabetic Vision: Learn how proactive blood sugar control can prevent diabetic retinopathy. Early detection is key. #DiabeticRetinopathy #eyehealth #diabetesmanagement’

What is Diabetic Retinopathy?

Diabetic retinopathy is an eye disorder that can result in vision loss and blindness in diabetics (). High blood sugar levels have an effect on blood vessels in the retina, which is the light-sensitive layer of tissue at the back of the eye. The injured tissue reduces oxygen delivery to the retina and causes swelling as the eye attempts to build new blood vessels. The eye is harmed because these new blood vessels do not form properly and can leak easily. Sometimes, retinal blood vessel injury causes an accumulation of fluid (edema) in the retina's center (macula) and the vitreous chamber.

Scar tissue from the formation of new blood vessels might eventually cause the retina to detach from the back of your eye. The fluid pressure can damage the nerve that sends images from your eye to your brain (optic nerve), resulting in glaucoma. Diabetic retinopathy is normally asymptomatic until the retina detaches and vision fades. "This is why it's important to detect diabetes at a young age," explains Dr. Natarajan.

Diabetic Retinopathy Affects 26% of Americans
Discover the latest research on diabetic retinopathy in the US. Learn about its prevalence, implications, and essential preventive measures for preserving vision.

Diabetic Eye Complications: Beyond Retinopathy and Cataracts

By 2030, the overall number of diabetic retinopathy cases (both vision-threatening and non-threatening) worldwide is predicted to reach 191 million (). With over 100 million diabetics in India and at least 58% unaware that they have this metabolic illness, combining an eye exam with diabetes screening becomes critical. Apart from diabetic retinopathy, the younger population with diabetes is also prone to cataracts.

Diabetic Retinopathy Can Worsen With Low Blood Sugar Levels
People with diabetes who have low blood sugar episodes, which are prevalent in people new to blood sugar management, are more likely to have progressive diabetic eye damage.

How to Spot Early Retinal Changes

The prognosis of diabetic retinopathy is determined by the stage of the disease. With the help of contemporary management techniques, vision can be retained or restored if discovered early. This would entail strict diabetes control, the use of retinal lasers, injections, and so on. Vitreoretinal surgery may be required in advanced stages, with a guarded visual prognosis ().

There are cutting-edge technologies for detecting diabetic retinopathy, such as wide-field fundus photography (which provides a broad field picture of the retina without dilation of the pupil) and retinal OCT, which shows extremely early retinal edema. AI is also being used to diagnose diabetic retinopathy in remote regions, allowing for timely referrals and the preservation of vision. There are currently approximately 25,000 ophthalmologists and 30,000 optometrists serving a population of 1.4 billion. "However, with the primary goal of early detection, even unskilled workers can be trained on how to use a mobile phone, the apparatus, and take photographs. We can protect the eyes," Dr. Natarajan explains. Even if your vision appears to be fine, you should have an annual eye exam with dilation if you have diabetes.

References:

Diabetic Retinopathy - (https://www.ncbi.nlm.nih.gov/books/NBK560805/)
Prevalence, Progression, and Modifiable Risk Factors for Diabetic Retinopathy in Youth and Young Adults With Youth-Onset Type 1 and Type 2 Diabetes: The SEARCH for Diabetes in Youth Study - (https://pubmed.ncbi.nlm.nih.gov/37043887/)
Diabetic Retinopathy: Pathophysiology and Treatments - (https://pubmed.ncbi.nlm.nih.gov/29925789/)
The worldwide epidemic of diabetic retinopathy - (https://pubmed.ncbi.nlm.nih.gov/22944754/)
The Evolving Treatment of Diabetic Retinopathy - (https://pubmed.ncbi.nlm.nih.gov/32184554/)

Source-Medindia

Diabetic Retinopathy Affects 1 in 3 People With Uncontrolled Diabetes
Diabetic retinopathy can affect one out of every three patients with uncontrolled diabetes for 10-12 years.