What Is Diabetes Mellitus?
Diabetes mellitus is a chronic disease associated with abnormally high levels of the sugar glucose in the blood. Diabetes mellitus is a major global public health problem.
Diabetes Mellitus Is An Epidemic Due To
- Longer life span
- Modern lifestyle (urbanization)
- Environmental and social factors (Diet, obesity and physical activity)
WHO estimates that in year 2030, Malaysia would have 2.48 million people with diabetes mellitus 48% of diabetics (age>40 year old) are not aware that they have diabetes.
Complications Associated With Diabetes Mellitus
- Diabetic retinopathy
- Kidney failure
- Heart disease
- Diabetic neuropathy
- Diabetic foot disease
What Is Diabetic Retinopathy?
Diabetic retinopathy is a condition occurring in persons with long standing diabetes mellitus, which causes progressive damage to the retina, the light sensitive lining at the back of the eye. It is a serious sight-threatening complication of diabetes.
Over time, too much sugar in the blood can lead to the blockage of the tiny blood vessels that nourish the retina, cutting off its blood supply. As a result, the eye attempts to grow new blood vessels. But these new blood vessels don’t develop properly and can leak easily.
Sign And Symptoms Of Diabetic Retinopathy
- No symptom in early stage of diabetic retinopathy
- Seeing spots or floaters in field of vision
- Blurred vision
- Having dark or empty spot in the center of vision
- Difficulty seeing well at night
- Diplopia (double vision)
- Red eyes
- Increased intraocular pressure in the eye
Diabetic Retinopathy Risk Factors
- Duration of diabetes mellitus – the longer the duration the higher the risk
- Poor control of blood sugar level
- Obesity
- Smoking
- Other medical condition – high blood pressure and high cholesterol
- Pregnancy in diabetics
Types Of Diabetic Retinopathy
- Non-proliferative retinopathy is an early form of the disease, where the retinal blood vessels leak fluid or bleed.
- Macular oedema is a swelling of the macula, caused by the leakage of fluid from retinal blood vessels. It can damage central vision.
- Proliferative retinopathy is an advanced form of the disease and occurs when blood vessels in the retina disappear and are replaced by new fragile vessels that bleed easily, and that can result in a sudden loss of vision.
Complications
- Vitreous hemorrhage
- Retinal detachment
- Glaucoma
- Blindness
How Often Should I Be Checked To Make Sure My Eyes Are Okay?
A dilated eye examination is recommended at the time of diagnosis. The doctor will recommend follow-up visits based on your condition. Most patients require yearly dilated eye examinations.
The best way to prevent unnecessary vision loss is through annual retina eye exams. People may not know that their vision has been damaged until it’s too late. Through early detection of diabetic retinopathy, several treatment options can be offered to a patient.
Treatment For Diabetic Retinopathy
- Laser – focal / grid
- Intraocular steroids
- Intraocular anti vascular endothelial growth factor (anti-VEGF)
- Surgical treatment – vitrectomy
 |
 |
Diabetic Retinopathy Screening
Non mydriatic digital fundus camera in eye examination is very useful. Fundus images captured can be graded by credentiallied and privileged staff such as staff nurses, optometrist, medical officers and family medicine specialist. Several abnormalities in diabetic retinopathy
| – Abnormal blood vessel | – Bleeding in vitreous |
| – Swelling, blood or fatty deposits in the retina | – Retinal detachment |
| – Growth of new blood vessels and scar tissue | – Abnormalities in optic disk |
Tips To Prevent Diabetic Retinopathy
- Control glucose level
- Control blood pressure
- Stop smoking
- Encourage exercise
- Reduce weight
- Yearly eye examination or follow schedule by doctor
Diabetic retinopathy often has no early warning signs. Screening diabetic retinopathy is essential for early detection and early treatment. Don’t wait for symptoms. Vision loss or blindness may be preventable through early detection and timely treatment. Be sure to have a comprehensive eye exam at least once a year to detect the disease before it causes damage to your vision.
References
- http://www.moh.gov.my/attachments/6601.pdf
- www.aoa.org
- www.betterhealth.vic.gov.au
- www.mayoclinic.org
- www.medicinenet.com
- www.moh.gov.my
- www.retinaassociates.org
- www.retinaeyedoctor.com
- www.who.int/mediacentre/factsheets/fs138/en/
| Last Reviewed | : | 30 May 2016 |
| Writer | : | Pn. Ainayanty Binti Adnan |
| Translator | : | Pn. Ainayanty Binti Adnan |
| Accreditor | : | Pn. Normala Binti Sami |
