Diabetes: A global killer
Diabetes Mellitus is a disease of the metabolism in which there is insufficient control of blood glucose levels. The inability to control blood sugar levels arises from poor production of a hormone called insulin or poor sensitivity by your body cells to the insulin produced. This leads to high levels of glucose in your bloodstream. There are two main types of diabetes: Type 1 and Type 2 Diabetes Mellitus.
Type 1 diabetes is an autoimmune condition in which your immune system destroys insulin producing cells of your pancreas. It is mostly diagnosed in childhood but it can also occur in adulthood. This type accounts for 10% of all diabetes. Studies have found that the majority of people with type 1 struggle with glucose management despite advances in insulin therapy.
Type 2 diabetes is the most common form diabetes and is related to lifestyle factors such as obesity, lack of physical activity and family history. This accounts for 90% of diabetes. One of the key interventions for this type is lifestyle change and medication.
The World Health Organization estimates that there are 830 million people globally living with diabetes and the majorities are in low and middle-income countries. It was reported that over 50% of those living with diabetes are not receiving treatment.
Diabetes and its role in the eye.
Diabetes in the eye causes diabetic retinopathy and cataracts. Diabetic retinopathy is the disease of the light focusing structure of the eye called the retina. It is the most common sight-threatening complication of diabetes in the eye. This condition causes weakening of the walls of the blood vessels in the retina leading to bleeding, leakage of fluid from these blood vessels, formation of abnormal new blood vessels, and swelling of the macula. In the early stages structural damage occurs without any noticeable vision changes. High levels of sugar can lead to the formation of cataracts. For this reason, it is important to proactively screen diabetic patients regularly.
What is Diabetic screening in the Eye and why is it important.
Eyecare professionals such as Optometrists and Ophthalmologists play a crucial role in diagnosing and managing diabetic retinopathy. Diabetic retinopathy screenings typically involve the following visual tests:
- Visual acuity testing: this checks the clarity of your vision and the focusing of your eyes.
- Retinal imaging: pictures of the back of your eye called the retina are taken to assess the condition of your blood vessels, optic nerve, macula and other parts of your retina.
- Subtle changes may require more advanced imaging tools such as Optical Coherence Tomography( OCT) which provides a cross-sectional view of the retina.
- Ophthalmoscopy is a test can help check for cataracts.
Eye health screenings are essential as they can:
- Help detect early signs of diabetic retinopathy. This will help evaluate any signs of retinal bleeding, swelling and any new blood vessel growth.
- If one already has diabetic retinopathy, regular screenings assist in monitoring any progression of the disease.
- Detect visual acuity changes.
- Increase your awareness of the diabetes
- They also help create collaboration between different health professionals.
At the forefront of management is emphasis on strict blood glucose level control. Clinical trials such as the UK Prospective Diabetes Study and the Diabetes Control and Complications Trials have indicated the benefits having your blood sugar levels under control.
“Life does not stop with diabetes, it is only a call to live more consciously. Therefore, managing diabetes is about small, consistent choices- one step at a time towards a healthier life.”
References
Adler, A. I., Coleman, R. L., Whiteley, W. N., & Holman, R. R. (2025). The legacy effect of hyperglycaemia in type 2 diabetes – Authors’ reply. The Lancet, 405(10472), 29. https://doi.org/10.1016/S0140-6736(24)02384-5
Duh, E. J., Sun, J. K., & Stitt, A. W. (2017). Diabetic retinopathy: current understanding, mechanisms, and treatment strategies. JCI Insight, 2(14). https://doi.org/10.1172/jci.insight.93751
Nathan, D. M. (2014). The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study at 30 Years: Overview. Diabetes Care, 37(1), 9–16. https://doi.org/10.2337/dc13-2112
Wang, W., & Lo, A. C. Y. (2018a). Diabetic Retinopathy: Pathophysiology and Treatments. International Journal of Molecular Sciences, 19(6), 1816. https://doi.org/10.3390/ijms19061816
Wang, W., & Lo, A. C. Y. (2018b). Diabetic Retinopathy: Pathophysiology and Treatments. International Journal of Molecular Sciences, 19(6), 1816. https://doi.org/10.3390/ijms19061816