Diabetes? 4 Things You Need to Know

I tell every new diabetic patient I meet 4 things: 

1. they are going to develop diabetic retinopathy
2. regular eye exams prevent vision loss
3. good sugar control doesn’t save them
4. and their other doctors are dead wrong. 

It is a message I have developed to hammer home the idea that diabetic retinopathy can be blinding and most doctors don’t understand  how this disease affects the eyes.  There are many misconceptions about the disease.

1.  Every Diabetic Develops Diabetic Retinopathy

Diabetic retinopathy develops in most patients.  The average diabetic patient develops signs of the disease 7 years after the diagnosis of becoming diabetic.  In over 18 years of practice, I have seen fewer than 10 patients that do not have diabetic retinopathy, yet have been diabetic for over 30 years.

In my mind, this means that most, if not all, diabetic patients will get the disease.

2.  Regular Exams Prevent Vision Loss

Dilated eye exams are recommended at the time of diagnosis and then annually – even if there is no diabetic retinopathy.  Why? 

First, we don’t know when diabetes actually starts, so it is a good idea to look for disease at the time of diagnosis.  Second, diabetic retinopathy can develop while a patient is still 20/20.  The goal is to catch the disease and treat, while the vision is still perfect.  We don’t want to wait until there is decreased vision.  So, regular examination prevents vision loss.

3.  Good Sugar Control Does Not Prevent the Disease

This is the biggest myth.  While it is true that the severity of the disease is may be limited with sugar control, most people (and a lot of doctors) believe that good control of the blood sugar prevents diabetic retinopathy.

It does not.

4.  Doctors Really Don’t Know

I am constantly surprised that many doctors don’t know that every patient with diabetes, regardless of the vision (good and bad), need a dilated eye exam every year.

Many doctors don’t know that a patient with excellent vision and/or good sugar control can still develop diabetic retinopathy.

What Does This Mean?  If the development of diabetic retinopathy is inevitable, or at least highly likely, then the patient can’t be blamed for NOT taking good care of themselves. 

My message removes the blame.  Do you enjoy being contantly reminded when you are making mistakes?  Of course, not.  Would you keep going to the doctor if every time you were being told you were ugly?  Noone likes to be nagged or blamed.

My message also lets patients know that they can be rewarded by maintaining regular visits…we can prevent significant vision loss, and most cases are able to prevent any vision loss at all.

Have a great weekend.