Day: September 26, 2025

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Having a healthy metabolism is a key to general wellbeing. It determines the way the body utilizes energy, glucose levels, and essential body functions. Healthy eating has been one of the best ways to safeguard and enhance metabolism health. The type of foods we eat daily is strong enough to balance hormones, add energy and decrease the chances of developing diseases. Through a healthy, balanced diet, we can boost our metabolism and establish an improved health base in the future.

Understanding Metabolic Health

Metabolic health is defined as a normal operation of your body metabolism, the way of how it uses the food to produce energy. Not only does it concern weight, but a whole-body examination of how effectively your body utilizes and stores energy. Being in good metabolic health may reduce your chances of having chronic diseases like type 2 diabetes, heart disease and stroke.

Key indicators of metabolic health

Medical workers consider a variety of biomarkers. They are usually measured during a general physical check-up to determine your metabolic health:

• Blood sugar: The normal level of blood sugar in the body means that you have enough insulin to break down sugar into energy. Fluctuating levels may be an indication of insulin resistance.
• Waist circumference: Fat around the belly (an apple shape) is a major risk factor of metabolic syndrome. A set of diseases that puts you at risk of heart disease and diabetes.
• Blood pressure: Having high blood pressure on a chronic basis can hurt your heart and blood vessels.
• Triglycerides: A large amount of these blood fats may put you at risk of heart disease.
• HDL (good) cholesterol: Low amounts of HDL cholesterol levels can predispose you to heart disease.

A combination of three or more of these risk factors can indicate metabolic syndrome. 

How Nutrition Affects Metabolism

Nutrition directly affects your metabolism by influencing your energy intake and expenditure, regulating blood sugar, and providing the necessary building blocks for all of your body’s processes. The quality and type of food you eat can either optimize or impair your metabolic health. 

The role of macronutrients

• Carbohydrates: Your body’s primary energy source.
  • Metabolic effect: The nature of the carbohydrate is important. Uncomplicated, complex carbohydrates (such as sugary beverages, white bread) induce fast glycemic surges, which could result in insulin resistance and type 2 diabetes. Complicated carbohydrates in whole grains, fruits, and vegetables maintain a slower and more steady discharge of energy.
• Proteins: Proteins, which are vital in making and repairing tissues, possess a greater “thermic effect,” or your body expends more energy to digest it than fats and carbs.
  • Metabolic effect: Lean protein diet can temporarily increase your metabolism and retain muscle mass to avoid the metabolic slowdown that is accompanied by weight loss.
• Fats: While fat has the highest energy density, the type of fat consumed is critical.
  • Metabolic effect: Unsaturated fats (nuts, seeds, oils, etc.) may enhance the metabolic health, decrease inflammation and increase insulin sensitivity. In contrast, too much saturated and trans fats may lead to metabolic disorders. 

The impact of food processing

• Highly processed foods, such as fast food, packaged snacks, and sugary drinks, are detrimental to metabolic health.
  • Nutritional deficiencies: Processing usually takes away healthy nutrients such as fiber, vitamins, and minerals and imparts too much sugar, salt, and unhealthy fats.
  • Fast digestion: Processed food is very rich in refined carbohydrates and low in fiber, thus digestible quickly, which results in blood sugar surges and crashes.
  • Damage to gut health: Processed foods can ruin your gut microbiome, and unbalanced microbiome is associated with metabolic dysregulation. 

The importance of micronutrients and fiber

• Micronutrients (vitamins and minerals) are vital for metabolic function, acting as cofactors for enzymes involved in energy production.
  • Examples: Deficiency of vitamin D is associated with metabolic syndrome and such minerals as magnesium and zinc are important in insulin sensibility.
• Dietary fiber plays a key role in metabolic health, primarily by feeding beneficial gut bacteria.
  • Metabolic effect: Fiber fermentation by intestinal microbes gives rise to short-chain fatty acids that play a wide range of physiological functions that can enhance insulin sensitivity, decrease inflammation, and aid in the regulation of appetite. 

Healthy Eating Habits for Better Metabolic Health

Healthy eating habits form a foundation of enhancing metabolic health through efficient control of blood sugar, weight management, and prevention of metabolic-related chronic illnesses. What, when, and how you consume food will enable you to maximize the utilization of energy and metabolism in your body.

Focus on nutrient-dense, whole foods

• Make protein a priority: Add lean protein foods such as fish, eggs, beans and chicken to all the meals. Protein aids in regulating blood sugar, it enhances satiety, and it preserves muscle mass which is a significant glucose consumer.
• Load up on fiber: Foods rich in fiber, including vegetables, fruits, and whole grains, aid in controlling blood sugar and maintaining a healthy microbiome of the gut. Fiber can make you fuller as well which can combat overeating.
• Practice healthy fats: Include healthy fats such as avocados, nuts, seeds and olive oil. Healthy fats enhance sensitivity of Insulin and may lower insulation which helps in metabolic health. 

Be mindful of meal timing

·       Eat more often: Time you’re eating behaviors according to the circadian rhythm of your body and eat most of your calories during the morning. High-calorie breakfast is associated with more weight loss and better glucose and insulin responses than high-calorie dinner.

·       Eat regular-balanced meals: Frequent, balanced meals keep blood glucose levels constant and eliminate energy crashes and overeating. Missing meals would slow down your metabolic rate.

·       Limit nighttime eating: Do not eat late at night, late night eating has been associated with glucose intolerance, fatteries and weight gain.

Practice mindful eating and portion control

• Eat consciously: Be aware of the eating experience, enjoy the taste and the texture. It could assist you in becoming aware of the natural signals of hunger and fullness in your body and avoid overeating.
• Control portions: Half of your plate of vegetables can help you control the size of portions. Conscious eating enables one to control the sugar and hormone levels in the blood that determine the feeling of fullness.
• Meal prep: Plan and pre-cook meals ahead of time to stay in charge of nutrition and not resort to unhealthy and impulsive food when you are in a hurry. Meal prepping is also beneficial in terms of portion control and consistency.

You may also like to read: Prenatal Vitamins

Consequences of Poor Eating on Metabolism

Mistresses diet is damaging to your metabolism and usually results in a variety of chronic health problems. Diet rich in processed foods and sugar, low in fiber and consumed at unusual hours may essentially disturb the metabolism in the body.

The consequences of a poor diet

• Weight gain: Overconsumption of calories particularly sugary beverages and processed foods can cause weight gain and become obese. This overweight is a major risk factor towards metabolic syndrome especially around the abdomen.
• Frequent spikes in blood sugar: High-refined carbohydrate diets and the addition of sugars lead to insulin resistance and type 2 diabetes. In the course of time, the cells of your body might become less sensitive to insulin, and it is known as insulin resistance. This may cause type 2 diabetes, when not controlled.
• Liver is damaged and fats: The liver processes fructose, a kind of sugar that is common in processed food and sugary drinks the way it processes alcohol. The abundance of fructose may increase the fat level in the liver which is part of non-alcoholic fatty liver disease, a predisposing factor to diabetes and heart disease.
• Gut microbiome dysbiosis: The unequal diet, especially high in sugar and unhealthy fats, can disrupt the balance of your gut bacteria. This dysbiosis may decrease useful bacteria and enhance inflammatory types, which lead to metabolic imbalances and chronic and low-grade inflammation.
• Avoiding regular eating patterns: Missing meals or having late meals are known to disrupt the metabolism of your body. When you spend extended time without meals the body must be in survival mode and as a result, your metabolism will decrease, and the energy will be stored. Abnormal eating has also been attributed to increased insulin resistance and metabolic syndrome.
• Low activity and tiredness: A fluctuating level of blood sugar due to a large consumption of simple sugars may cause the phenomenon of a high and low energy level. This impacts your vitality, mood and state of mind. 

Impact on the metabolic cycle

The metabolic cycle is influenced by food quality and consistency. 

• Diet with a high level of fiber and nutrients with regular eating time helps in maintaining a balanced metabolism.
• Poor intake of fiber and excess sugar, infrequent eating leads to disrupted metabolic signaling, which causes weight gain, resistance to insulin and systemic inflammation.

Bottom Line

To sum up, proper nutrition is a key to good metabolic activity, as it allows the body to work effectively and reduces the chances of chronic illnesses. Through wholesome, nutrient-rich foods and mindful eating, we will be able to contribute to energy balance, enhance long-term well-being, and resilient metabolism. Even minor changes in the daily meal can have long term effects of benefit to health and vitality.

FAQs

Q: How do I understand metabolic health?

Metabolic health is characterized by the optimal level of 5 clinical markers blood sugar, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference. The individual values as well as the variability of these markers are important in helping to decode your metabolic health.

Q: What is the biggest metabolism killer?

Overall, high saturated fats, sodium, and added sugars, coupled with low antioxidants, fiber, vitamins, and minerals are the worst foods to have regarding your metabolism. These foods (and beverages) may elevate the exposure to inflammatory and oxidative stress, which preconditions ill metabolic health.

Q: How to reset metabolism after 40?

1. Eat at regular times.
2. Eat enough calories.
3. Eat more protein.
4. Drink green tea.
5. Lift weights.
6. HIIT.
7. Drink more water.
8. Manage stress.

Q: Can sleep affect your metabolism? There are increased research and interest that sleep disorders and sleep loss affect metabolism. Lab research has made it very clear that sleep deprivation has the capability of modifying the glucose metabolism and hormones in metabolism regulation, that is, the reduction in leptin and the increase in ghrelin.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

One of the eye complications that are commonly associated with diabetes and a major cause of vision loss throughout the world is diabetic retinopathy. Unattended, it may silently develop and destroy the sensitive blood vessels in the retina causing blurred vision or even blindness. Luckily, there are some useful means to treat and cope with this disorder using modern medicine. We shall briefly examine the various treatment opportunities that exist with diabetic retinopathy in this article and how patients can hope to achieve once care is obtained in time.

What is Diabetic Retinopathy?

Diabetic retinopathy is the most frequent diabetic complication that impairs blood vessels of the retina, the light sensitive tissue at the back of the eye, which is the main cause of vision loss and blindness.

Treatment Options for Diabetic Retinopathy

Diabetic retinopathy treatment depends on stage and severity of the disease but includes management of blood sugar to highly complex surgical interventions. It is aimed to stop the development of the disease and avoiding further loss of vision because in many cases, previously damaged parts of the eye are irreversible.

Medical management

In the case of early-stage diabetic retinopathy, an ophthalmologist can only prescribe routine follow-up and rigid control of your general condition.

• Diabetes management: This is through strict regulation of your blood sugar level, which will prevent or at least delay the disease.
• Blood pressure and cholesterol: High blood pressure and high cholesterol can be treated and help to lessen the risk of the worsening of retinopathy.
• Fenofibrate: In individuals with non-proliferative diabetic retinopathy (NPDR), a cholesterol-lowering drug known as fenofibrate has been proven to decrease the chances of the condition progressing even those with normal lipid levels. 

Eye injections

The swelling of the macula (central part of the retina) and growth of new, fragile blood vessels is treated with injections of medication directly into the eye to prevent the disease.

• Anti-VEGF drugs: These encompassed Avastin, Eylea, Lucentis, and Vabysmo, which are anti-vegetable endothelial growth factor (VEGF) drugs, which enlarges and permeabilizes blood vessels. One of their uses is as a first-line therapy of diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR).
• Corticosteroid implants – In cases where there is no response to anti-VEGF therapy, steroid drug could be injected or implanted into the eye and the drug would be slowly released over a few months.
• Refillable eye implants: Newly approved models, including Susvimo, are provided with a refillable implant that pumps a specific level of a customized formulation of ranibizumab to the eye. 

Laser treatments

Laser treatments can seal leaking blood vessels and shrink abnormal new ones. 

• Focal or grid laser: This is done in the treatment of DME. It uses laser burns that are directed at ruptured blood vessels in the macula.
• Scatter (panretinal) photocoagulation: It is applied to cases of diabetic retinopathy which is advanced and proliferative. The laser produces small, scattered burns to the peripheral retina which shrink and disappear into the abnormal new blood vessels.

Eye surgery (Vitrectomy)

Surgery is typically reserved for advanced cases where other treatments are not sufficient. 

• When is it needed? A vitrectomy can be used in case of severe bleeding in the vitreous gel which fails to clear, the presence of a lot of scar tissue pulling the retina, or a detached retina.
• What happens during surgery? The surgeon takes out the hazy vitreous gel and a scar tissue and puts in a clear saline solution or a gas or oil bubble to cushion the retina. 

Emerging therapies

Ongoing research is exploring new and more effective treatments for diabetic retinopathy, including: 

• New anti-angiogenic drugs
• Oral medications
• Stem-cell therapy
• Gene therapy

Although the damage cannot be reversed, treatment can help prevent or delay additional damage to the vision. Having an integrated approach and a high level of diabetes control is usually the best course of action.

You may also like to read: Preventing Vision Loss from Diabetic Retinopathy

Expected Outcomes by Treatment Type

Treatment of diabetic retinopathy aims at preventing or halting the disease progression and to avoid severe loss of vision. The level and form of your condition, the method of treatment, and your health, in general, blood sugar control, are among the factors that define the exact outcome you can expect. Although it can be improved, particularly when the disease is diagnosed in the early stages, in most cases, it is impossible to undo all the harm.

Expected outcomes by treatment type

• Often improve vision significantly in diabetic macular edema.
• Results are best with consistent and ongoing treatment.

• Reduces the risk of severe vision loss by more than 50%.
• May cause side effects like reduced night or peripheral vision.

• Effective for advanced cases like retinal detachment or hemorrhage.
• Can stabilize or improve vision, especially with early intervention.

Factors influencing long-term outcomes

The long-term prognosis is heavily influenced by several factors, many of which you can actively manage.

• Treatment adherence: It is important to adhere to your treatment program because under-treatment is one of the leading causes of a poor outcome in the real world.
• Management of diabetes: Glycemic control (HbA1C), blood pressure control and cholesterol control divert renal injury disease progression and enhance treatment results.
• The severity of the disease at diagnosis: the later the diabetic retinopathy is diagnosed and treated, the better the outcome is. Delaying action after the vision has been seriously affected may cause permanent structural harm.
• The basic retinal damage: The treatment can correct fluid and bleeding; however, the visual prognosis is constrained by the level of irreparable harm to the photoreceptors and retinal nerve cells that might have taken place.

Final Thoughts

Therapy of diabetic retinopathy is aimed at reducing the course of the disease, preserving the vision, and enhancing the quality of life. Although the results are not identical at each phase of the condition and different types of treatments are applied, early diagnosis and regular treatment can significantly help in saving vision. Medical therapy together with proper management of diabetes can help patients deliver positive long-term outcomes and minimize chances of losing their sight severely.

FAQs

Q: What is the 4 2 1 rule for diabetic retinopathy?

The diagnosis is based on the 4-2-1 rule. Diagnosis is made when the patient has, in 4 quadrants, diffuse intraretinal hemorrhages and microaneurysms, in 4 quadrants, venous beading, and in 1 quadrant, IRMA.

Q: Can mild diabetic retinopathy be reversed?

Treatment may delay or prevent the progression of diabetic retinopathy, but it is not a cure. Diabetes is a long-term health condition and as a result, future retinal injury and vision impairment can still occur. Regular eye exams will be required even after diabetic retinopathy is treated. There may be a time you require supplementary treatment.

Q: What is the new treatment for retinopathy?

Basel, 22 May 2025 – Roche (SIX: RO, ROG; OTCQX: RHHBY) has announced that Susvimo® (ranibizumab injection) 100 mg/mL is now approved by the US Food and Drug Administration (FDA) in the treatment of diabetic retinopathy (DR), a potentially blinding disorder, which is present in nearly 10 million individuals in the USA.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

One of the most prevalent complications of diabetes and the major cause of vision loss in the globe is diabetic retinopathy. It arises when excess sugar harms the tiny blood vessels in the retina and it slowly impairs the vision. The fact that sight impairment in diabetic retinopathy may be averted in most cases through management of diabetes, eye checkups, and healthy lifestyle is good news. In this article, we’ll explore effective strategies for preventing vision loss from diabetic retinopathy and protecting long-term eye health.

Understanding Diabetic Retinopathy

Diabetic retinopathy is a disease of the eye that is caused by diabetes and is caused by the destruction of blood vessels in the retina. It is a major cause of blindness in adults and may occur in all those with Type 1, Type 2 or gestational diabetes.

Why Prevention is Crucial

Disease is important in preventing diabetic retinopathy, which is asymptomatic at its onset and causes permanent loss of vision when not treated. Protect your sight by detecting diabetes early and managing its risk factors proactively.

Benefits of prevention

• Avoids permanent vision loss: Treatments could delay the development of advanced diabetic retinopathy, but not permanent damage already inflicted. The early case of identification can be treated before it is too late to cause serious damage to your eyes. As a matter of fact, 90 percent of eye diabetes can be avoided at an early age with proper treatment.
• Improves treatment outcomes: In the case of eye problems, early diagnosis can be treated with less aggressive methods, which can eventually help to avoid more radical treatment of eye surgery in the future.
• Reduces healthcare costs: Early prevention of diabetic eye complications is much cheaper and easier than treating mature disease.
• Enhances quality of life: Good vision enables one to stay independent and well in general. By avoiding vision loss, you are capable of living your day to day life without restrictions.

Key Strategies for Preventing Vision Loss

• Regulate blood sugar: Maintaining blood sugar at a target level is the best thing you can do to prevent or delay diabetic retinopathy.
• Manage blood pressure and cholesterol: High blood pressure and high cholesterol may speed up the damage of your eyes. Having them checked keeps the fine blood vessels of your retina safe.
• Regular eye checkouts: Annual comprehensive and dilated eye tests are necessary since in most cases diabetic retinopathy at an early stage no symptoms are visible. Your eye doctor would be able to notice the change and act before vision is impaired.
• Live a healthy lifestyle: A healthy eating pattern and physical activity are some of the ways to manage your blood sugar levels and enhance your health condition, including vision.
• Stop smoking: Smoking exposes one to complications of diabetes and eye problems. By giving up, you can have better health and decrease your risk.

Treatment Options if Retinopathy Develops

In the event of diabetic retinopathy, a few methods of treatment are possible, based on the severity and type of complications involved. Treatments can halt or delay the disease in most instances and can even prevent degraded vision.

Injections (Intravitreal)

Diabetic macular edema (DME) is a common complication of retinopathy whose most common and usual treatment is injections of medicine directly into the eye (intravitreal injections).

• Anti-VEGF drugs: The medications inhibit a protein known as vascular endothelial growth factor (VEGF), which stimulates the unnatural development and permeability of blood vessels. Injections of anti-VEGF diminish the swelling and allow new vulnerable vessels to develop. They are Aflibercept (Eylea) and Ranibizumab (Lucentis).
• Corticosteroids: Steroid injections are also applicable to alleviate inflammation and macular swelling. They are commonly used when the anti-VEGF injections fail.

Laser treatments

Laser treatments are used to target specific problems in the retina caused by diabetic retinopathy. 

• Focal/Grid Laser Photocoagulation: This is a laser therapy to treat DME by closing leaking blood vessels in a localized area. It is used to swell and stabilize vision.
• Panretinal Photocoagulation (PRP): PRP is applied in more severe, proliferative diabetic retinopathy (PDR) to shrink and destroy the new, abnormal blood vessels. Laser is used on the outerretina, not the macula, to prevent VEGF production.

Surgery (Vitrectomy)

For the most advanced cases of diabetic retinopathy, surgery may be necessary. 

• Vitrectomy: A surgeon in this process removes the vitreous gel in the middle of the eye. This is required when the bleeding in the vitreous is severe (vitreous hemorrhage) or when the scar tissue of abnormal new blood vessels is pulling the retina (tractional retinal detachment). 

Underlying diabetes management

The management of the underlying diabetes is important in the slowing down of diabetic retinopathy despite the treatments. This involves close control of blood sugar, blood pressure and cholesterol and may be in partnership with your primary care physician and other specialists.

Should you have special questions regarding the treatment of diabetic retinopathy or desire to learn what may be advised at your current phase of the disease, it is always best to have a specialist in the field of retina consult you. To assist, I can locate information on the preparation of a visit to an ophthalmologist or research local specialists on the retina.

You may also like to read: Importance of Eye Exams in Diabetes Management

Final Thoughts

The prevention of diabetic retinopathy vision loss begins with prophylactic care and proper management of diabetes. The risk of severe eye damage can be minimized by maintaining a normal level of blood sugar, blood pressure and cholesterol, frequent eye check-ups, and healthy lifestyle patterns. The most important thing is to act at the earliest stage and be treated in time not only to save your sight, but your life.

FAQs

Q: Can diabetic retinopathy go away?

A: While treatment can slow or stop the worsening of diabetic retinopathy, it’s not a cure. Because diabetes is a lifelong health problem, future retinal damage and vision loss are still possible. Even after treatment for diabetic retinopathy, you’ll need regular eye exams.

Q: Can you drive with diabetic retinopathy?

A: Dark or shadowy spots in your vision: when Diabetic Retinopathy makes the field of vision blurred or dark, the number of points lost in your vision is high. In case you have over three adjacent points missing and your retinopathy is not stable yet, then it is possible that you should not drive.

Q: What worsens diabetic retinopathy?

A: Inadequate diabetes management, which fails to keep blood sugar levels within a healthy range, can increase the rate of progression. Obesity can also be a risk factor for diabetic retinopathy progression.

Q: How do you stop diabetic retinopathy from progressing?

A: Lifestyle changes are also important in the management of the condition in both cases. Diet, exercise, and medication can help maintain blood sugar levels within the target range and avoid additional harm to the eyes and delay the evolution of diabetic retinopathy.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Having diabetes does not only mean checking the blood sugar levels but also being attentive to your health and particularly the eyes. Unconsciously, high blood sugar levels can destroy small blood vessels in the eyes, causing such diseases as diabetic retinopathy, macular edema, cataracts, and glaucoma. Eye check-ups are essential to measure diabetes, as it is important to identify these problems at an early stage, and to avoid vision impairment and improved long-term health results.

Why Are Eye Exams Essential for People with Diabetes?

Diabetics should get eye tests because diabetes may severely damage the eyes, particularly the tiny blood vessels in their retinas, resulting in diabetic retinopathy- the most common reason behind diabetic patients losing their vision. The early signs of this and other eye diseases caused by diabetes including macular edema, cataracts, glaucoma and dry eye can be detected by regular diabetic eye tests. Timely diagnosis through thorough examinations with retina dilation can either avoid or at least postpone loss of sight by laser treatment or injection. Diabetics are highly advised to undergo annual ocular check-ups despite possibly having normal eyesight since monitoring eye health is the best way to address risks.

Why Eye Exams Matter in Diabetes

• Diabetes may lead to leakage, bleeding, and loss of vision in the retinal blood vessels.
• The retinopathy of diabetes occurs in approximately 1 of 3 individuals with diabetes and typically does not have any symptoms at an early stage.
• Annual eye test with pupil dilation makes sure that the retina is well inspected to identify any changes at an early stage.

Preventive Role of Eye Exams

• Early diagnosis results in intervention that could prevent blindness.
• Eye tests also identify other eye problems that are related to diabetes such as cataracts and glaucoma.
• Normal blood sugar level and frequent check-ups help to avoid eye complications.

Common Eye Conditions Linked to Diabetes

Common eye conditions linked to diabetes include:

·       Diabetic Retinopathy: It is the most prevalent disease that is caused by diabetes which involves a high sugar level damaging the blood vessels of the retina, resulting in leaking, swelling, and new abnormal blood vessels growing. It may result in blindness and loss of vision.

·       Diabetic Macular Edema: This is a form of diabetic retinopathy in which the patient experiences fluid accumulation in the macula (central part of the retina that provides the ability to see finer details) resulting in swelling and distortion of vision. It causes moderate to severe vision loss in diabetes.

Glaucoma: Diabetics are at a higher risk of having glaucoma, a disorder of high pressure that destroys the optic nerve and may cause loss of sight.

Blurred vision: High blood sugar may lead to the swelling of the lens, which will temporarily blur vision until the levels of sugar come to normal.

Cataracts: Diabetes makes the lens inside the eye cloud because in diabetes; cataract develops at an earlier age than non-diabetic people do.

The eye conditions usually have no symptoms in their early stages, so regular eye examination is essential in detecting and treating them to avoid loss of eyesight.

What Happens During a Diabetic Eye Exam?

During a diabetic eye exam, several key steps are performed to thoroughly assess the health of the eyes and detect any diabetes-related damage:

• Visual Acuity Test: During the test, the eye chart begins by testing the acuity of the eye on both short-range and long-range vision (Snellen chart).
• The Special eye drops are applied to enlarge the pupils (widen the eye) so that the eye doctor can have a clearer look at the retina and optic nerve at the back of the eye. Such dilation can lead to blurred vision and sensitivity to light in a few hours.
• Retina and Optic Nerve Examination: The doctor examines the retina, blood vessels and optic nerve, and other internal organs in the eye using a magnifying lens and a bright light or special imaging cameras to detect diabetic retinopathy, macular edema, and other complications.
• Tonometry: this is a test used to measure the pressure in the eye to rule out glaucoma that is more prevalent in diabetic patients.
• Advanced Imaging (when necessary): An imaging method such as Optical Coherence Tomography (OCT) and retinal photography is used to give detailed cross-sectional and photographic images of the retina to detect minor changes or problems in blood vessels.
• Slit Lamp Examination: Slit lamp Microscope is used to observe the internal structures and the surface of the eye carefully.

The doctor then talks about the results of the exam and can prescribe treatments or care. It is recommended that patients come with someone to drive them back home because of temporary blurred vision, dilation causes, and bring glasses or contact lenses, sunglasses and questions about their vision and diabetes.

You may also like to read: Diabetic Retinopathy

How Often Should People with Diabetes Get Eye Exams?

People with diabetes should get eye exams regularly to monitor and prevent diabetes-related eye complications. The general recommended frequency is:

• For Type 1 Diabetes: The first comprehensive eye exam should be within five years after diagnosis, then annually thereafter.
• For Type 2 Diabetes: The first comprehensive eye exam should be done immediately upon diagnosis, with yearly follow-ups.
• Pregnant women with diabetes should have an eye exam as soon as possible after pregnancy is confirmed and may require more frequent exams during pregnancy.
• If diabetic eye disease is detected, more frequent exams will be recommended as needed.

Annual dilated eye exams are crucial because diabetes-related eye conditions often have no early symptoms but can progress silently to serious vision loss. Consistent yearly screening helps in early detection and timely treatment, which can prevent up to 95% of diabetes-related vision loss. Sometimes, based on individual risk and exam results, doctors may extend the exam interval to every 1-2 years, but annual exams remain the standard guideline.

Final Thoughts

In conclusion, regular eye exams are an essential part of diabetes management, helping to detect complications early and protect long-term vision. By combining routine checkups with healthy lifestyle choices and proper diabetes control, individuals can significantly reduce their risk of vision loss. Prioritizing eye care not only safeguards sight but also supports overall well-being in the journey of living with diabetes.

FAQs

Q: Why are eye exams important for diabetics?

A: As a person with diabetes, your annual eye exam is the best way to determine if your blood glucose (blood sugar) levels are affecting the health of your eyes. Even if your vision is completely normal and your eyes feel fine, you could be experiencing the earlier stages of a diabetes-related eye condition.

Q: What are the objectives of diabetic eye screening?

A: The NHS Diabetic Eye Screening Program aims to reduce the risk of sight loss among people with diabetes by the prompt identification and effective treatment of sight-threatening diabetic retinopathy, at the appropriate stage of the disease process.

Q: How to protect eyes from diabetes?

Ways you can help prevent eye problems caused by diabetes include:

1. Control your blood sugar. Your doctor can provide directions on how to keep your blood sugar normal and avoid fluctuations that can lead to diabetic eye diseases.
2. Lower your blood pressure and cholesterol.
3. Stop smoking.
4. Avoid harmful rays.

Q: What’s the best vitamin for diabetic eyes?

A: Various studies have indicated that vitamins C, D, E, B1, folate, B12, lipoic acid, lutein, n-acetyl cysteine, and betaine may help to improve endothelial functioning, prevent neuronal damage, reduce blood pressure, and enhance visual acuity.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

One of the most frequent and severe effects of diabetes is diabetic retinopathy, which targets the minute blood vessels of the retina of the eye. When unattended, it may result in eye defects and even blindness. Knowing the causes, early symptoms, and the treatment options available are very crucial measures for safeguarding the eye health of any diabetic person.

What is Diabetic Retinopathy?

Diabetic retinopathy is a diabetes complication affecting the eyes. It is brought about by the injury of blood vessels in the sensitive tissue in the back of the eye known as the retina. The damage is because of the high blood sugar, which damages the small blood vessels in the retina, resulting in leakage, swelling, or irregular growth of blood vessels.

At its initial phases, diabetic retinopathy can have no symptoms or mild vision issues, which include floaters, blurred vision, or dark spots. When not treated, it may advance blindness or extreme loss of sight. The risk is augmented by the period of diabetes and the absence of control of blood sugar.

Causes

High blood sugar (glucose) levels, which are caused by diabetes, are the main cause of diabetic retinopathy. In the long run, this surplus sugar destroys the tiny blood vessels that supply the retina causing them to weaken, block and leak.

The major mechanisms and causes are:

• Damage and weakening of blood vessels in the retina resulting in small dots (microaneurysms) that can leak fluid or blood into the retina.
• Obstruction of blood vessels in the retina resulting in ischemia in the retina.
• In reaction to obstructed vessels, new abnormal blood vessels develop (proliferative diabetic retinopathy). These are the new vessels which are weak and liable to leakage and bleeding.
• Macula edema (fluid in the macula) leads to swelling and vision loss.
• Chronic high glycemia activates processes leading to oxidative stress, inflammation, and vascular impairment in retinal tissue.

Other risk factors that lead to the development and progression of diabetic retinopathy are poor glycemic control, high blood pressure, obesity, elevated cholesterol, smoking, nephropathy, hormonal effects, and genetic factors.

Symptoms

The symptoms of diabetic retinopathy often do not appear in the early stages. When symptoms develop, they can include:

• Spots or dark strings floating in the field of vision, called floaters.
• Blurred or distorted vision.
• Changes in vision quality, including difficulty seeing in low light or darkness.
• Dark or empty areas in vision.
• Impaired color vision, including colors appearing faded or washed out.
• Poor peripheral (side) vision.
• Nearsightedness or farsightedness and fluctuating vision.
• Gradual worsening of eyesight, which can eventually lead to vision loss.

It can affect one eye or both eyes and the symptoms are likely to exacerbate as the disease advances. Blurry or spotty vision, sudden changes in vision are symptoms to be taken to the doctor. Early detection through frequent eye tests is crucial because the symptoms at early stages could either be absent or mild.

Diagnosis of Diabetic Retinopathy

Diabetic retinopathy is mostly diagnosed by thorough dilated eye examination where eye care specialists apply drops to dilate the eyes to aid in further inspection of the retina to assess any signs of damage.

Common diagnostic methods include:

• Dilated Eye Exam: Drops are used to enlarge the pupils to enable a closer look at the retina and blood vessels detecting abnormalities such as microaneurysms, hemorrhages and leakage.
• Optical Coherence Tomography (OCT): This is a non-invasive test of the retina, which forms cross-sectional images of the retina, visualizing its thickness and fluid accumulation or swelling (macular edema).
• Fluorescein Angiography: A dye is given into an arm into a vein, and images are made as the dye passes through the blood vessels in the retina indicating blocked, broken or leaking vessels.
• Visual Acuity Testing: Tests the clearness and sharpness of the vision.
• Slit Lamp Examination and Ophthalmoscopy: To take a closer look at the various aspects of the eye such as the retina and the existence of unwanted blood vessels.

Further examinations can determine systemic variables such as HbA1c results to check blood sugar regulation and retinopathy developmental risk factors.

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Treatment Options

Diabetic retinopathy can be treated based on severity and presentation. Common treatments include:

·       Laser Photocoagulation: Diabetic retinopathy (PDR)- Proliferative-type-only; diabetic macular edema (DME). Panretinal photocoagulation (PRP) uses laser spots on the peripheral retina to inhibit the abnormal growth of vessels whereas focal/grid laser uses laser on leaking blood vessels in the macula to reduce swelling. This cure allows one to avoid serious vision loss.

·       Intravitreal Injections: VEGF-inhibitory drugs (anti-VEGF) (e.g., ranibizumab, aflibercept, bevacizumab) are injected into the eye to prevent VEGF, which stimulates abnormal vessel development and leakage. To inhibit inflammation and macular edema, corticosteroid injections could also be applied. These injections are frequently repeated.

·       Vitrectomy Surgery: It is done in severe cases when there is vitreous bleeding or detachment of the retina. The doctor removes blood/scar tissue out of the vitreous cavity and fixes the retina. This is normally used in cases of serious diseases where other medicine proves to be ineffective.

·       Medications: Oral medications such as fenofibrate can reduce the risk of progression, particularly in non-proliferative diabetic retinopathy.

Systemic treatment of blood sugar, blood pressure, and cholesterol is also essential in the management of these eye treatments to reduce the rate of disease progression.

Bottom Line

Diabetic retinopathy is a gradual eye disease that may be very severe unless treated in its early stages. With proper control of the blood sugar levels, regular eye check-ups, and prompt treatment, diabetes patients can significantly lower the chances of losing their sight. Concern and active care are the best instruments in maintaining healthy eyesight.