DIABETES

Diabetes is a major health issue in North America. There are approximately 1.4 million people in Canada with diabetes and this number is expected to increase to 3 million by 2010. According to the Ontario Ministry of Health as many as 200 000 residents in Ontario have the disease and do not even know it.

Why is the incidence of diabetes still increasing at alarming rates? One factor is the improved methods of diagnosis which makes it easier to identify new diabetics. Most experts place most of the blame primarily on the apparent epidemic of obesity in our society today. Obesity presents many health risks; developing diabetes being the greatest.

Diabetes is a disease in which the blood glucose levels are too high. After a meal food is broken down into a sugar called glucose which is transported by the blood to the cells throughout the body. Insulin is needed to convert the glucose into energy. With Type1 or early-onset diabetes there is a lack or absence of insulin in the body to perform this process. Type 2 or late-onset diabetics produce enough insulin; however the body does not properly use it to convert the glucose into energy. Prolonged increased blood glucose levels can lead to nerve and blood vessel damage which ultimately can result in stroke heart disease blindness extremity amputation and even death.

The most damaging eye condition caused by diabetes is diabetic retinopathy. The incidence of this disease increases the longer someone has diabetes. Diabetic retinopathy causes the blood vessels of the retina (inner layer of the back of the eye) to leak swell or develop abnormally which causes damage to the retina. This can result in vision loss that can range from mild to severe.

Laser surgery can be used by an ophthalmologist to minimize the damage caused by diabetic retinopathy. However laser surgery must be done in a timely fashion to be effective and it does not always return vision back to normal levels.The lasers used to treat diabetic retinopathy are much different than the lasers used for refractive eye surgery. Another surgical option for patients suffering from persistent diabetic retinopathy involves the surgeon injecting the eyeball with a steroid to stabilize the damaging effects of the retinopathy. There are now new medications that can be injected in the eyeball that can prevent the growth of the abnormal blood vessels seen in diabetic retinopathy.

Very often people with diabetes do not know that they have diabetic retinopathy until significant damage is done to the retina. Prevention of diabetic retinopathy is best accomplished by maintaining normal blood glucose levels blood pressure and blood lipid levels. A regular eye exam (minimum once a year) by an optometrist or ophthalmologist is essential to catch retinal changes as early as possible.