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Against the worldwide epidemic

Editor-in-chief's editorial

Diabetes and eye disease: what people with diabetes and healthcare professionals need to know

The good news is that most cases of severe vision loss due to diabetes are preventable; the bad news is that tens of thousands of people lose vision to diabetes each year despite all we know about prevention and treatment. Indeed, diabetes is a leading cause of vision loss around the world. Compared with the general population, people with diabetes have a 25-fold increased risk of blindness.


Diabetes and visual impairment - identifying needs, ensuring full accessibility

Many people with diabetes live with some form of visual impairment due to a variety of possible causes. Visual impairment due to diabetic retinopathy is a long-term complication of the condition. Diabetes also raises the risk for visual impairment due to cataracts, glaucoma and stroke. Age-related macular degeneration is not caused by diabetes, but like type 2diabetes, it occurs more frequently as people age, and many people have both.

The need for tact, openness and honesty when talking about complications

Discussing the sensitive issue of long-term complications is difficult for people with diabetes and the healthcare providers who work with them. Consequently, this area of diabetes management is often not handled well. In some situations, healthcare providers are reluctant to impose 'unpleasant' information on people who might be struggling to cope with diabetes; in others, the potential risk of developing complications might be used as a threat in an attempt to scare people into following medical advice.

Protecting eyesight, feet, and the nervous system

Classically, diabetes complications are thought of as damaging the heart and blood vessels, eyes, kidneys and nervous system. Blood vessel damage, together with nerve damage, leads to foot problems. Protection of the heart, blood vessels and kidneys is dealt with in an earlier article, as is protection of all of these by control of blood glucose levels. Here we describe how disabling problems which are developing in the eyes, feet, and nervous system despite those measures can be managed optimally.

Worsening the blow: the effects of smoking on diabetes complications

Cigarette smoking is a serious hazard to health. Yet, although as a group people with diabetes are at increased risk of developing cardiovascular disease, this does not appear to influence smoking habits among them. Tobacco use among people with diabetes is strongly associated with a further increase in the risk of developing cardiovascular complications. Furthermore, research has indicated that smoking has negative effects on the metabolism of glucose and lipids (fat), leading

How does smoking affect insulin sensitivity?

It is well known that tobacco smoke is harmful to health and is of particular danger to people with diabetes. All of the chronic complications of diabetes – such as cardiovascular disease, foot problems, kidney disease, and eye damage – are exacerbated by breathing in tobacco smoke. Recently, it was suggested that smoking may increase the risk of developing type 2 diabetes. Although the exact mechanisms are not yet fully understood, it has been suggested that impaired sensitivity to the action of insulin in people who smoke tobacco could be linked to

Cause as well as effect: smoking and diabetes

People who smoke tobacco are at increased risk of cardiovascular disease. Tobacco use contributes to the risk of all the major types of cardiovascular disease, particularly heart attack, stroke and the blockage of blood vessels in the lower limbs. People with diabetes, especially type 2 diabetes, are also at high risk for

Seeing it right: accessible information for the visually impaired

Failure to provide accessible information for blind and partially sighted people is both unacceptable and unnecessary. It is unacceptable in that it is a denial of a fundamental right to information. It is unnecessary in that it makes no sense on business grounds. Providing information in alternative formats need not be expensive or difficult; large print, audio tape and computer files can be easily provided without specialist equipment.

Preventing blindness online

Individuals with diabetes are 25 to 30 times more likely to lose their sight from diabetic eye damage (retinopathy), cataracts or glaucoma. The US National Eye Institute reports that almost half of the 16 million people with diabetes in America have at least early signs of diabetic retinopathy. Nearly 700,000 people have serious retinal disease, and as many as 25,000 people go blind from diabetic retinopathy. In light of these statistics, Prevent Blindness America (PBA), the oldest volunteer eye health organization in the United States, has launched a new website, www.diabetes-sight.org.

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