Diabetes is the number 1 cause of kidney failure, lower limb amputations, and adult blindness. In addition to blindness, diabetes can cause other devastating eye issues. Approximately 30.3 million Americans have diabetes and 1 in 4 of them are not aware that they even have it. Diabetes is the 7th leading cause of death in the United States. The numbers are staggering but what are the different types of diabetes, what is diabetic retinopathy, and what are other common forms of eye issues that can occur from having diabetes?
Types of Diabetes
Information in this section was taken from the Mayo Clinic, Centers for Disease Control and Prevention and WebMD. In addition to the three types of diabetes, the sub-category of “prediabetes” will also be looked at in this section.
Type 1 Diabetes: Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy. Different factors, including genetics and some viruses, may contribute to type 1 diabetes. Although type 1 diabetes usually appears during childhood or adolescence, it can develop in adults. (see this WebMD article for advice on type 1 in children by age).
Type 2 Diabetes: With type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. About 90% of people with diabetes have type 2. It develops over many years and is usually diagnosed in adults (but more and more in children, teens, and young adults). You may not notice any symptoms, so it’s important to get your blood sugar tested if you’re at risk. Type 2 diabetes can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy food, and being active. Risk factors include being overweight, aged 45 or older, having a close family member with it, being physically active less than 3 days a week, and being of certain races (including African American, Hispanic/Latino, American Indian, Alaska Natives, Pacific Islanders, and some Asian Americans).
Gestational Diabetes: Diabetes when you’re expecting affects about 4% of all U.S. pregnancies. It’s caused by hormones the placenta makes or by too little insulin. High blood sugar from the mother causes high blood sugar in the baby. That can lead to growth and development problems if left untreated. Risks include having had it with a previous pregnancy, having given birth to a baby over 9 pounds, are overweight, aged 25 or older, having a family history of diabetes, having polycystic ovary syndrome, or being one of the races outlined under type 2 diabetes.
Prediabetes: In the United States, 84.1 million adults—more than 1 in 3—have prediabetes. What’s more, 90% of them don’t know they have it. With prediabetes, blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Prediabetes raises your risk for type 2 diabetes, heart disease, and stroke. The good news is if you have prediabetes, a lifestyle change program can help you take healthy steps to reverse it. Risk factors are the same as those listed under type 2 diabetes.
According to the National Eye Institute, diabetic retinopathy is an eye condition that can cause vision loss and blindness in people who have diabetes. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye). If you have diabetes, it’s important for you to get a comprehensive dilated eye exam at least once a year. Diabetic retinopathy may not have any symptoms at first — but finding it early can help you take steps to protect your vision.
In later stages of the disease, blood vessels in the retina start to bleed into the vitreous (gel-like fluid in the center of the eye). If this happens, you may see dark, floating spots or streaks that look like cobwebs. Sometimes, the spots clear up on their own — but it’s important to get treatment right away. Without treatment, the bleeding can happen again, get worse, or cause scarring.
Diabetic retinopathy can lead to other serious eye conditions:
Diabetic macular edema (DME): Over time, about half of people with diabetic retinopathy will develop DME. DME happens when blood vessels in the retina leak fluid, causing swelling in the macula (a part of the retina). If you have DME, your vision will become blurry because of the extra fluid in your macula.
Neovascular glaucoma: Diabetic retinopathy can cause abnormal blood vessels to grow out of the retina and block fluid from draining out of the eye. This causes a type of glaucoma.
Retinal detachment: Diabetic retinopathy can cause scars to form in the back of your eye. When the scars pull your retina away from the back of your eye, it’s called tractional retinal detachment.
To see illustrated videos on diabetic retinopathy see the article What is Diabetic Retinopathy?
Other Common Eye Conditions
Diabetic retinopathy is the most common cause of vision loss for people with diabetes. But diabetes can also make you more likely to develop several other eye conditions:
Cataracts: Having diabetes makes you 2 to 5 times more likely to develop cataracts. It also makes you more likely to get them at a younger age. All About Vision defines cataracts as the clouding of the eye’s natural lens. It is the most common cause of vision loss in people over age 40 and is also the principal cause of blindness in the world. When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, strong bifocals, magnification, appropriate lighting or other visual aids. Think about surgery when your cataracts have progressed enough to seriously impair your vision and affect your daily life.
Open-angle glaucoma: Having diabetes nearly doubles your risk of developing a type of glaucoma called open-angle glaucoma. The Glaucoma Research Foundation defines open-angle glaucoma as an eye disease that gradually steals vision. There are typically no early warning signs or painful symptoms of open-angle glaucoma. It develops slowly and sometimes without noticeable sight loss for many years. The initial loss of vision is of side or peripheral vision, and the visual acuity or sharpness of vision is maintained until late in the disease. By the time a patient is aware of vision loss, the disease is usually quite advanced. Without proper treatment, glaucoma can lead to blindness. The good news is that with regular eye exams, early detection, and treatment, you can preserve your vision.