Q: My son was diagnosed with type 1 diabetes last year, and we are trying to learn how best to protect his eyesight. What should we be doing?
A: Type 1 diabetes is the type that most often impacts younger people, while type 2 more often affects adults. Type 1 often requires insulin as the pancreas is not producing this critical hormone adequately. Type 2 is more often controlled with oral medications.
We have known for a long time that the longer someone is diabetic, the more likely diabetic effects or damage will occur. This is extra important for young people as they have so many years ahead to prevent vision damage or loss. Fortunately, today glucose monitoring is far better than decades ago. And while insulin injections are commonplace, newer insulin pumps provide more stable levels without those unpleasant injections.
A recent study published in the Journal of the American Medical Association Ophthalmology found that among numerous factors, “glycemic control” was the most influential risk factor for diabetic retinopathy. With over 9000 patients studied, keeping your A1C level low and stable was the best indicator of glycemic control and risk of eye damage. Retinopathy refers to vascular damage inside the eyes that can lead to leakage or bleeding inside the eye. Even worse, new unhealthy blood vessels can begin to grow inside the eye which can leak badly.
Other factors like hypertension, obesity, and being overweight also contribute to more diabetic damage such as retinopathy, the A1C levels was foremost. In our clinic, we too often have patients of all ages with diabetes but unaware of their A1C number. Be sure your next lab work includes your A1C level and make sure you know it. It has been said we have an “epidemic” of diabetes in this country, because more and more people are developing it. And too many are becoming diabetic at younger ages. Genetics, diet, lack of exercise, and more are critical in minimizing the many effects of T1D, as type 1 diabetes is often called.
Have a good discussion with your family physician and/or endocrinologist about your son’s condition. Have a thorough eye examination every year to detect the earliest stages of diabetic retinopathy. Like so many eye diseases, there is no pain or feeling to warn of damage inside the eyes. Vision changes are commonly the only warning sign people notice.