In this article, we will look at concepts such as non-proliferative diabetic retinopathy, proliferative retinopathy, and diabetic cataract.
What organs are primarily affected in a disease such as diabetes mellitus?
It is no secret that complications of diabetes mellitus are a topic that worries absolutely all patients with such a diagnosis. We propose to start considering it with the most sensitive organ, which often suffers from diabetes – from our eyes.
The eyes have a rather complex structure that corresponds to the function they perform. A simplified diagram of this structure looks as follows: on the path of light entering the eye, there is a lens – a lens that changes its curvature, so that a person can see both far and near. The main property of the lens lens is transparency.
After that, light begins to hit the back wall of the eye. There are cells in the retina that process the energy of light into the energy of a nerve impulse that enters the brain through the optic nerve. It is there that the final formation of the visual image takes place. These cells of the eye function most intensively. The retina is attached to the back wall of the eyeball only in two places. Thus, there is no strong connection between the retina and other structures of the eye. But, at the same time, it adheres quite tightly to the cells that feed it.
Decreased vision in diabetes is often caused by diseases such as cataracts or diabetic retinopathy – a diabetic change in the fundus of the eye.
Let’s try to imagine what happens to the vessels when “sweet” blood flows through them. Let’s imagine that this happens in the retinal capillaries. Cells expect nutrients from the vessels, but they cannot receive them, since the vessels are “clogged” with “ excess” carbohydrates . In this case, the vessels lose their strength, become crimped, and easily burst. The main sign of the later stages of this complication is a decrease in visual acuity. This condition of the retina is called diabetic retinopathy.
Retinal detachment can be caused by any hemorrhage. The fact is that there is no strong connection between the retina and its surrounding tissues. And hemorrhages can occur even if the vessel is damaged as a result of high sugar levels. In the event of such detachment, the main part of the visual cells is immediately deprived of nutrition and dies. As a result, visual acuity is sharply reduced.
There are cases when vision does not decrease for a long time in diabetic retinopathy, but changes occur along the periphery of the fundus. In this situation, immediate treatment using a laser is necessary. Laser surgery is used to improve or stabilize vision and to prevent future vision decline.
Is such a serious complication curable? The answer to this question depends on the stage of the process and its severity. The sooner changes in the fundus are detected, the more realistic it is to stop their development in the future. Glasses in this case are helpless. Unfortunately, at the moment there are no methods of transplant or any other type of eye replacement.
The main measures for the prevention of the above complications
It is no secret that there are various pills ( trental , parmidin, doxium , etc.). They say that with the help of drugs such as trental , doxium , parmidin, there is a possibility of preventing these complications.
It is important to remember that the pills that are used to treat these complications of diabetes cannot affect the main cause of their occurrence: high blood glucose levels. They have a certain effect on the vessels, but they will not work properly until the patient is able to compensate for the high blood sugar.
The demand for such tablets can be attributed to advertising. But at the same time, they are very expensive, and their effectiveness is often not proven. Is there any point in looking for new drugs, wasting precious time? After all, is it much easier to establish self-control, follow a diet, learn how to properly dose insulin, depending on what needs the body expresses, get rid of excess weight and achieve normal blood sugar levels? Thanks to devices such as blood glucose meters , people with diabetes can measure their blood glucose readings quickly, easily, and at any time. For patients with diabetes who have complications in the eyes, blood glucose meters with a large type Contour TS are perfect .
Remember once and for all that the use of tablets is ineffective, in other words, they do not work on high sugar. The patient can take additional vitamins for diabetic patients, but first of all, he needs to normalize blood sugar, which is simply impossible without self-control. To improve the condition of the retina, experts often recommend taking antioxidants – tanakan , vitamin E, askorutin , etc. Antioxidants (for example, GLUCOBERRY) provide nonspecific protection of the body against various damaging and stress factors.
The surgical treatment for diabetic retinopathy is called laser photocoagulation.
A laser is a focused, thin beam of light. It helps to eliminate pathological foci on the retina, get rid of altered vessels that can provoke hemorrhage. There are also cases when the retina seems to be “welded”, and even if its detachment has already begun, then it does not occur in the future. The operation is completely painless and is performed on an outpatient basis. Today it is the only effective method of treatment and prevention of problems such as diabetic retinal detachment and progression of retinopathy. This operation will give the expected effect only if the patient normalizes the blood glucose level.
Recall that the most important preventive measure is the normalization of blood sugar. In patients with the first type of diabetes, this is achieved by the correct dosage of insulin, and in patients with the second type of diabetes, by adhering to a diet, an exercise regimen that helps to reduce body weight to normal.
Each patient diagnosed with diabetes mellitus must be examined by an ophthalmologist twice a year, who must examine the fundus of the eye with a dilated pupil in a dark room. It is advisable to be observed by one ophthalmologist or photograph the fundus.
The lens (lens) – just like the retina, can lose its function. Chronically elevated blood glucose is also a reason for this .
This complication is called cataract or lens opacity. In this case, the lens loses its transparency. This leads to the fact that light ceases to penetrate into the eye, and vision is significantly impaired.
The vessels of the eye are very close to the lens. With normal blood sugar levels, nothing happens to it. With a prolonged increase in blood glucose, “excess” sugar begins to penetrate into the thickness of the lens. In this case, not only glucose leaves the vessels, but also mineral salts and liquid. They gradually accumulate in the thickness of the lens, thus causing its opacity and the development of cataracts.
In case of cataracts in the later stages, the “dirty lens” is simply removed. After this operation, the patient becomes out of focus and is prescribed strong lenses. After such an operation, patients are often transplanted with a new lens, but this does not eliminate the need to wear glasses. Moreover, if it is not possible to eliminate the main cause of the complication – chronically elevated glucose in the blood, then the new lens will also become cloudy.
Various drops are sometimes used as a treatment. But they do not have a strong effect, since the cornea, consisting of several layers, is in their path. This is what prevents the droplets from penetrating to the lens. But even if they did get into the lens, then with increased blood sugar, they would not have the desired effect. Vitamin drops are recommended for use in old age. This is due to the fact that they slow down the maturation of the cataract, thus delaying the operation. But it is impossible to cure an already existing cataract with such drops.
Another complication of diabetes is the development of glaucoma (increased intraocular pressure). This complication is often treated with eye drops (such as pilocarpine), which have a beneficial effect on fluid drainage from the eye. In this case, as in the previous ones , the main reason for the development of complications is an increased blood sugar level.
As you can see, it is possible to prevent the occurrence and development of complications that negatively affect the vision of a patient with diabetes only if the patient strictly follows all recommendations for self-control. These recommendations must be followed even when complications are already developing. In some cases, this causes the reverse development of complications and even partial restoration of the lost functions of certain organs.