Brazil has 16.8 million people with diabetes and ranks fifth in the world in terms of the number of people with the disease, according to data from the IDF (International Diabetes Federation). Indiana University researchers have discovered diabetes biomarkers that allow them to diagnose changes in a diabetic’s retina prior to clinical diagnosis.
The ophthalmologist Leôncio Queiroz Neto says that it is common for patients to discover diabetes in the ophthalmologic consultation, when the first alterations in the retinal vessels have already appeared. The new biomarkers further advance diagnosis and therefore help to preserve vision.
The specialist says that it is not common to feel changes in vision at the beginning of diabetes. The most frequent symptoms are:
– excessive thirst;
– frequent urination;
– weight loss;
But, according to Leôncio, despite being common, these symptoms do not appear at all. Therefore, those who have cases in the family must undergo a clinical check-up periodically. A simple blood count can prevent serious complications.
Here are some vision problems that can be caused by diabetes
loss of vision
In the pandemic, the treatment of many patients was discontinued, the problem is that good glycemic control is not enough for the diabetic to continue seeing. It also depends on how long you live with the disease.
After five years, the risk of developing edema in the macula increases – the central portion of the retina, formation of new vessels that weaken the membrane and formation of deposits of sorbitol, a substance that favors the leakage of fluid from the vessels and leads to loss of vision.
Treatment includes laser application, anti-angiogenic injections, and surgery in cases of retinal hemorrhage or detachment.
The ophthalmologist explains that the higher the blood glucose, the greater the blood viscosity that leads to myopia. “This happens more often after meals when the glucose level rises”, he explains.
In women, he notes, water absorption through the lens can be greater because of estrogens and lead to a higher degree of nearsightedness. Prolonged periods of fasting cause the lens to dehydrate and myopia disappears.
Therefore, before prescribing glasses, the ophthalmologist checks if the glycemic index is controlled. The doctor’s tip to maintain the stability of refraction and blood glucose is to eat every 3 hours, giving preference to whole grains, vegetables and fruits in small amounts.
The expert clarifies that the repeated hydration and dehydration of the lens alter its fibers, anticipating the formation of cataracts, opacification of the lens that accounts for 49% of cases of treatable blindness in Brazil.
The only treatment is surgery in which the opaque lens is replaced with an intraocular lens. “In the case of diabetics, the sooner the procedure is done, the better”, he says.
Cataracts reduce the amount of blue light that reaches the retina and with it the production of melatonin, a hormone that regulates our alertness and sleep. Diabetics who live with cataracts for a long time are stressed by sleepless nights, gain weight and increase insulin resistance.
Diabetic glaucoma is a secondary reaction to retinopathy. It is characterized by the formation of new vessels, reduced blood supply, eye inflammation. Difficulty outflow of aqueous humor causes increased intraocular pressure and optic nerve cell death.
The specialist emphasizes that renovascular glaucoma has a rapid evolution and the lost visual field is irrecoverable. Therefore, it is important that every person with diabetes has eye exams annually.
Eye changes that can be blinding usually appear after 10 years but it is continuous treatment that maintains vision.