Study Focuses On Relationship Between Glaucoma And Diabetes, Hypertension
Many Americans suffer from diabetes and hypertension and, according to a study by researchers at the University of Michigan Kellogg Eye Center, these individuals may have an increased risk of developing open-angle glaucoma (OAG). Dr. Joshua D. Stein Joshua D. Stein, M.D., M.S., a glaucoma specialist at Kellogg, led a research team that recently reviewed billing records of more than 2 million people aged 40 and older who were enrolled in a managed care network in the United States and who visited an eye care provider one or more times from 2001 to 2007. The researchers found that people with diabetes alone had a 35 percent increased risk of developing OAG and those with hypertension alone had a 17 percent increased risk. For people with both diabetes and hypertension, there was a 48 percent increased risk of developing OAG, the most common form of glaucoma in the country. The study focused on the possible associations between various components of metabolic syndrome—a collection of conditions that includes obesity, hypertension, diabetes, and hyperlipidemia (high cholesterol and high triglyceride levels)—that affects one fifth of the U.S. population. The Kellogg researchers also examined how each component increased or decreased the risk of glaucoma. While the researchers found that diabetes and hypertension increased the risk of OAG, the study showed that hyperlipidemia actually reduced by 5 percent the risk for developing the disease. Further research is under way to evaluate whether it is the hyperlipidemia itself, the medications used to treat the condition, or both that reduces the risk of glaucoma. Findings from this research may eventually lead to novel treatments for glaucoma. “Patients who have diabetes and hypertension are already known to be at elevated Continue reading >>
Diabetes And Your Eyesight
Diabetes is a complex disease resulting from the inability of the body to produce insulin, a hormone that takes sugar out of the blood and into cells where it can be used for energy. Without enough insulin, there is too much sugar in your blood. It’s like having a car full of gas but no key; you have the fuel you need, but can’t start using it. Diabetes affects more than 29 million Americans. The most common form of diabetes is adult-onset diabetes. Adult-onset diabetes typically strikes those who are over 40, overweight and have a sedentary lifestyle. Other risk factors include those with a family history of diabetes and those belonging to certain ethnic groups. Persons of African, Native American, Japanese, Latino or Polynesian descent are more at risk. Diabetic Eye Disease A common complication of diabetes is diabetic eye disease. Diabetic eye disease refers to a group of sight-threatening eye problems that people with diabetes may develop. Glaucoma is one of these diseases. Diabetic eye disease also includes diabetic retinopathy and cataracts. Diabetic retinopathy, a disease which damages the tiny blood vessels in the retina (the light-sensitive tissue that lines the back of the eye) is the most common diabetic eye disease. Diabetic retinopathy affects nearly 7.7 million Americans age 40 and older. A cataract is a clouding of the eye’s lens that results in blurring of normal vision. People with diabetes are nearly twice as likely to develop cataracts as other adults. Cataracts also tend to develop at an earlier age. Diabetes and Glaucoma The relationship between diabetes and open-angle glaucoma (the most common type of glaucoma), has intrigued researchers for years. People with diabetes are twice as likely to develop glaucoma as are non-diabetics, although som Continue reading >>
Eye Problems And Diabetes
Eye problems and diabetes introduction If you have diabetes, regular visits to your ophthalmologist for eye exams are important to avoid eye problems. High blood sugar (glucose) increases the risk of diabetes eye problems. In fact, diabetes is the leading cause of blindness in adults age 20 to 74. If you have eye problems and diabetes, don't buy a new pair of glasses as soon as you notice you have blurred vision. It could just be a temporary eye problem that develops rapidly with diabetes and is caused by high blood sugar levels. High blood sugar in diabetes causes the lens of the eye to swell, which changes your ability to see. To correct this kind of eye problem, you need to get your blood sugar back into the target range (90-130 milligrams per deciliter or mg/dL before meals, and less than 180 mg/dL one to two hours after a meal). It may take as long as three months after your blood sugar is well controlled for your vision to fully get back to normal. Blurred vision can also be a symptom of more serious eye problem with diabetes. The three major eye problems that people with diabetes may develop and should be aware of are cataracts, glaucoma, and retinopathy. A cataract is a clouding or fogging of the normally clear lens of the eye. The lens is what allows us to see and focus on an image just like a camera. Although anyone can get cataracts, people with diabetes get these eye problems at an earlier age than most and the condition progresses more rapidly than in people without diabetes. If you have a cataract, there is a cloudy area in the lens of your eye that results in the inability to focus light, and your vision is impaired. Symptoms of this eye problem in diabetes include blurred or glared vision. During cataract surgery, the cloudy lens is removed or cleaned ou Continue reading >>
Diabetes And Eye Problems (cont.)
Glaucoma and Diabetes When fluid inside the eye does not drain properly from a buildup of pressure inside the eye, it results in another eye problem with diabetes called glaucoma. The pressure damages nerves and the vessels in the eye, causing changes in vision. Treatment of open-angle glaucoma -- the most common form of glaucoma -- requires lowering the eye's pressure by increasing the drainage of aqueous humor or decreasing the production of the fluid. Medications can accomplish both of these goals. With open-angle glaucoma, there may be no symptoms of this eye problem at all until the disease is very advanced and there is significant vision loss. In the less common form of this eye problem, symptoms can include headaches, eye aches or pain, blurred vision, watering eyes, halos around lights, and loss of vision. Treatment of this eye problem in diabetes can include special eye drops, laser procedures, medicine, or surgery. Surgery and laser treatments are directed at improving the eye's aqueous drainage. You can prevent serious eye problems in diabetes problems by getting an annual glaucoma screening from your eye doctor. Diabetic Retinopathy The retina is a group of specialized cells that convert light as it enters though the lens into images. The eye nerve or optic nerve transmits visual information to the brain. Diabetic retinopathy is one of the vascular (blood-vessel related) complications related to diabetes. This diabetes eye problem is due to damage of small vessels and is called a "microvascular complication." Kidney disease and nerve damage due to diabetes are also microvascular complications. Large blood vessel damage (also called macrovascular complications) includes complications like heart disease and stroke. The microvascular complications have, in nume Continue reading >>
Clinical And Experimental Links Between Diabetes And Glaucoma
Glaucoma is a leading cause of blindness. It is a multifactorial condition, the risk factors for which are increasingly well defined from large-scale epidemiological studies. One risk factor that remains controversial is the presence of diabetes. It has been proposed that diabetic eyes are at greater risk of injury from external stressors, such as elevated intraocular pressure. Alternatively, diabetes may cause ganglion cell loss, which becomes additive to a glaucomatous ganglion cell injury. Several clinical trials have considered whether a link exists between diabetes and glaucoma. In this review, we outline these studies and consider the causes for their lack of concordant findings. We also review the biochemical and cellular similarities between the two conditions. Moreover, we review the available literature that attempts to answer the question of whether the presence of diabetes increases the risk of developing glaucoma. At present, laboratory studies provide robust evidence for an association between diabetes and glaucoma. Diabetes is a leading health priority, as it can cause severe systemic complications, such as retinopathy, neuropathy and nephropathy. This metabolic disorder results from either altered secretion of insulin by the pancreas (type 1 diabetes) or insulin resistance at a cellular level (type 2 diabetes). These changes produce widespread abnormalities in glucose uptake, resulting in hyperglycaemia, as well as abnormal metabolism and formation of lipids (Figure 1), which impact on neurons, blood vessels and glial cells. Indeed, this journal carries an excellent review on glial dysfunction in diabetic eyes.1 Many clinicians will be aware of diabetic retinopathy and its classification, as laid out by the National Health and Medical Research Council Gu Continue reading >>
Glaucoma, What Relationship Does It Have With Diabetes?
Glaucoma is one of the most common eye-related complications in people with diabetes. Learn to prevent it. No fewer than 4.5 million people around the world suffer from it, and it's estimated that by 2020 that number will rise to 11 million people. Even though it’s the second most common cause of blindness, there are still many people who have no idea of what it is. This is especially unfortunate because 90% of these cases of blindness could be avoided by an early diagnosis. Do you think you know everything about glaucoma? What is Glaucoma? It’s a progressive optical nervous disease, and unfortunately, it’s irreversible. Although many factors are involved in its development, pressure on the eye seems to be one of the main ones. And diabetes plays a key role: people with diabetes sometimes suffer from chronic glaucoma, a type of glaucoma that is no different from the type people without diabetes develop. Its treatment isn’t any different either, although we do have to be very careful about some adverse effects of the medication. Why does ocular hypertension occur? There is a clear watery fluid called “aqueous humor” which is present at the front of the eyes. In order to keep pressure steady on a healthy eye, a small amount of this aqueous humor is continuously produced. It flows through a tiny drain called the trabecular meshwork, a network of cells and tissues located in an area called the drainage angle. When this fluid can’t be reabsorbed (when there is an imbalance between production and reabsorption), pressure on the eye increases. What different types of glaucoma are there? There are many types, and each has a different origin and progression. Most cases are either chronic simple glaucoma or open angle Glaucoma. - Open angle glaucoma. When this type o Continue reading >>
Top Icd-10-cm Changes: Diabetes, Glaucoma And Macular Degeneration
On October 1, 2016, changes to ICD-10-CM coding were implemented. While all of the code changes applicable for optometry are important, a few of the major changes are discussed in this article. Diabetic Ocular Complication Codes The first major change in ICD-10-CM codes for 2017 is for diabetic ocular complication coding. All of the DM retinopathy code choices will now specify which eye is impacted. Several new codes for proliferative diabetic retinopathy were also added. Note that a code for oral diabetic medication use (Z79.84) was added and should be used when applicable. The existing code to designate insulin use (Z79.4) was retained. Keep in mind that not all injectable diabetic medications are considered insulin. If a patient is on both oral medication and insulin, both of these medication codes should be used. The new codes for diabetic retinopathy apply to all the code categories, but only the E11.3 code section is detailed in this article so be sure to review the other categories if you are using them for any particular patient. The other categories include E08.3, E09.3, and E10.3. E11.3 Type 2 diabetes mellitus with ophthalmic complications All of the subcategories under E11.3, with two exceptions, will require a 7th character to indicate which eye had retinopathy. One exception is E11.36 Type 2 diabetes mellitus with diabetic cataract. The other exception is E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication, but this code does require the use of an additional code to further describe the complication. The ICD-10-CM tabular listing for each of the following subcategories will require the following 7th character to be added as indicated by this statement under each subcategory: E11.32, E11.33, E11.34, and E11.35. As an example, all of Continue reading >>
Open-angle Glaucoma And Older-onset Diabetes: The Beaver Dam Eye Study
Purpose: To evaluate the relation of older-onset diabetes to open-angle glaucoma. Methods: During a population-based study of age-related eye disease (n = 4926), participants were evaluated for the presence of glaucoma. Glycosylated hemoglobin levels were measured, and a medical history was obtained. Results: Rates of persons meeting optic disc, visual field, and intraocular pressure criteria for definite glaucoma were more common in those with older-onset diabetes than in those without (4.2% versus 2.0%; P = 0.004). When persons with a history of treated glaucoma, despite whether they met the other criteria for glaucoma, were included, rates were 7.8% in those with diabetes compared with 3.9% in those without diabetes (P = 0.0005). Conclusions: The presence of open-angle glaucoma is increased in people with older-onset diabetes. Continue reading >>
How Are Dry Lips And Diabetes Related?
Dry lips is a symptom seen in diabetics and manifests with increased thirst. One of the early signs seen in diabetics is dry lips and mouth and patient feels thirsty all the time. It can also exacerbate the side effects of diabetes. For individuals suffering from diabetes, having a dry mouth can be quite annoying.Having a dry mouth, especially as a diabetic, can lead to rampant tooth decay and increased fungal infection which thereafore causes the blood sugar to increase as the body tries, and fails, to fight infection. A dry mouth can also lead to an altered taste sensation, a condition that presents with a metallic or sour taste in the mouth seen in diabetics. Because of the harmful effects of having a dry mouth, it is extremely important to keep the mouth hydrated with saliva. There are several ways to keep lips hydrated, and the easiest is to increase the intake of liquids throughout the day, which will then translate into a higher production of saliva, and a more balanced level of moisture in the mouth.Keep the blood sugar under control and follow a balanced diet rich in nutrients.All these help a diabetic maintain an overall health. Continue reading >>
Glaucoma And Diabetes: Can Diabetes Affect Your Eyes?
People with diabetes are twice as likely to be at risk of having glaucoma compared to people without diabetes. We will first look at how the eye works, what glaucoma is, followed by the relationship between glaucoma and diabetes. Clara’s story Clara’s eyes were feeling tired all of the time. She was attributing the tiredness to her Type 2 diabetes, but she wasn’t too sure about it. That’s why she contacted TheDiabetesCouncil to raise her concerns about the increasing pressure in her eyes. Her left eye had suddenly become red, and she was experiencing sharp pain in her eyes. She had somewhat of a headache, too. After hearing about Clara’s symptoms, she was advised to see her eye doctor for an examination, as glaucoma was suspected. Clara got in touch with us to report that she had been to her ophthalmologist, and she had been diagnosed with the most common type of glaucoma, open-angle glaucoma. She was using some drops in both eyes, and she relayed that she was feeling better, and that the pain in her eye and other symptoms have subsided. To help others in Clara’s situation, we have written this comprehensive guide about glaucoma and diabetes. How does the eye work? If you want to understand eye diseases, specifically glaucoma, it’s important to understand how the eye operates. It’s an incredible, wonderful organ! Without our eyes, we could not see the world around us. The eye is a spherically shaped organ that has a tough outer surface. The covering in the front of the eye is curvy. This covering is called the cornea. The cornea is responsible for focusing light. It also serves to protect the eye. Light makes its way through the eye by way of the anterior chamber. In this chamber, there is fluid called aqueous humor that the light travels through. Light Continue reading >>
Women With Type 2 Diabetes At Greater Risk For Glaucoma
Women with type 2 diabetes have a nearly twofold increased risk of developing primary open-angle glaucoma, the most common form of the disease. Among more than 76,000 women enrolled in the Nurses’ Health Study, those with type 2 diabetes had a relative risk for glaucoma of 1.82 even after the data were controlled for various glaucoma risk factors, said Louis R. Pasquale, M.D., and colleagues of the Massachusetts Eye and Ear Infirmary, and other Harvard-affiliated institutions. "While obesity fuels the type 2 diabetes epidemic, it appears that factors unrelated to obesity contribute to the positive association between type 2 diabetes and glaucoma; we were surprised to find this. "Our study had a large enough sample to allow us to focus on type 2 diabetes only and to study its relation to newly diagnosed primary open-angle glaucoma cases," they added. "We were also able to correct for other factors that could contribute to glaucoma. Our work suggests, but in no way proves, that factors other than lifestyle behavior contributing to insulin resistance could lead to elevated intraocular pressure and glaucoma." Primary open-angle glaucoma is the most common form of the disease, accounting for about 60% to 70% of all glaucoma cases. It’s one of the leading causes of blindness, and affects more than two million people in the United States, according to the National Eye Institute. In several large eye studies, type 2 diabetes has been associated with increased intraocular pressure, the most obvious sign of primary open-angle glaucoma. But although diabetes has been conclusively linked to retinopathy, its alleged association with glaucoma is controversial, Dr. Pasquale and colleagues wrote. To see whether there is an association between type 2 diabetes and glaucoma, the inves Continue reading >>
How Are Diabetes And Pancreatitis Related?
Pancreatitis is inflammation of the pancreas. There are many potential causes, but it can broadly be classified into two types: acute and chronic. Acute pancreatitis is inflammation that occurs over a short defined time window, whereas chronic pancreatitis is inflammation over a long period of time and can be episodic. The problem with inflammation is that it is damaging to tissue; indeed, the purpose of the immune system is to eliminate foreign pathogens. As a result of the inflammation-induced pancreatic tissue damage, the functions of the pancreas become compromised. The pancreas is responsible for secreting enzymes into the digestive tract to aid in the digestion of food, particularly fats. As a result, patients with pancreatitis can have diarrhea due to the excess fat in the stool. Because the beta cells of the pancreas are responsible for secreting insulin, which helps to reduce and regulate our blood glucose levels, in the setting of pancreatitis the pancreas cannot properly secrete insulin. As a result, pancreatitis patients present with the symptom of elevated blood glucose - diabetes. Continue reading >>
Glaucoma And Diabetes
Tweet Glaucoma may occur amongst people with and without diabetes, and can be a complication of diabetes if retinopathy develops. Glaucoma is caused by an excess amount of fluid pressing on the nerve at the back of the eye. How does glaucoma start? The eye produces a small amount of fluid like water in its middle chamber, which flows around the lens of the eye into the front chamber. The fluid leaves the eye using a drainage network and then enters the bloodstream. Commonly, glaucoma causes the drainage system to become blocked, and fluid becomes trapped in the eye. This causes pressure to build up in the eye and pass to the nerve at the rear of the eye. This nerve may become damaged by glaucoma. Is glaucoma linked with diabetes? People with diabetic retinopathy have an increased risk of glaucoma. This can happen if abnormal blood vessel growth, which can occur as a result of retinopathy, blocks the natural drainage of the eye. What are the symptoms of glaucoma? Glaucoma has very few symptoms in its early stage, so people may be unaware that something is wrong with them. As someone with diabetes, an optometrist or another eye specialist should test you for glaucoma at least once each year. How is glaucoma diagnosed? Glaucoma may be diagnosed by an optometrist by measuring your eye pressure, checking the eye at the optic nerve, and testing the field of your vision. A common test these days is a noncontact tonometry test (NCT test) in which a brief puff of air will be directed into the front of your eye. The machine you sit in front of measures the resistance of your eye to the puff of air without needing to make contact with your eye. The puff of air is noticeable but is not painful. Experts will quickly be able to determine if you have glaucoma. How is glaucoma treated? Continue reading >>
Diabetes Causes Glaucoma
Glaucoma is a disease that can lead to blindness by destroying the optic nerve. There is an increased risk in developing glaucoma if you have diabetic retinopathy. I am not aware of such a risk with macular degeneration. “Open Angle Glaucoma” is the Most Common for in the U.S. There are many types of glaucoma, but most common in the U.S. is “open angle” glaucoma. All the structures of the eye are normal, yet there tends to be an elevated eye pressure associated with typical glaucomatous nerve damage. Most treatments are aimed at lowering the eye pressure with drops. In many cases this may be an adequate way to slow down, or control the disease. Risk factor for developing open angle glaucoma includes race (especially blacks/african american), family history, increasing age and steroid users. There is mild increased chance of developing open angle glaucoma with …diabetes. There are generally NO symptoms with open angle glaucoma. It is painless and destroys optic nerve tissue very, very slowly. During almost any exam, however, your doctor generally checks your intraocular pressure, or, IOP. Glaucoma is not a cut and dry diagnosis, but higher than normal pressures probably warrant a glaucoma evaluation. Neovascular Glaucoma Hurts and Blinds Neovascular glaucoma can develop in patients with proliferative diabetic retinopathy. By definition, patients with proliferative diabetic retinopathy have neovascularization (abnormal blood vessels) growing on the surface of the retina or on other structures. If you recall, the neovascularization cause a diabetic retinal detachment, vitreous hemorrhage and neovascular glaucoma. At times, the abnormal blood vessels, the neovascular blood vessels, can grow over the “angle” of the eye. The “angle” is a specific area in the Continue reading >>
Doctor, I Have A Question.? What Is The Relationship Between Diabetes And Glaucoma? Written By Louis R. Pasquale, Md, Farvo
Assoc. Professor of Ophthalmology, Harvard Medical School Director, Glaucoma Service, Massachusetts Eye & Ear The relationship between diabetes and glaucoma can be controversial and confusing. First we must understand that there are two types of diabetes. In type 1 diabetes (T1D), there is a complete loss of the pancreatic beta cells that make insulin. The profound inability to make insulin in T1D necessitates that nearly all patients with this condition be treated with insulin replacement therapy. In type 2 diabetes (T2D), the cells that make insulin are not destroyed. In fact, T2D patients can typically make more insulin than patients without diabetes. When blood sugar levels are high, the secreted insulin is ineffective at lowering blood glucose levels, producing a state of insulin resistance. The treatment of T2D is often directed at lifestyle measures that reduce insulin resistance like diet and exercise, although some of these patients also require medications to lower blood sugar. Second, we must understand that there are many different types of glaucoma so we must both specify the type of diabetes (T1D or T2D) and the type of glaucoma we are referring to when we examine the relation between diabetes and glaucoma. One thing is clear: uncontrolled T1D or T2D for a long enough period will lead to the development of diabetic retinopathy, consisting of leaking blood vessels and poor retinal blood supply that disrupts retinal function. Left unchecked the retina becomes starved for oxygen and develops new blood vessels and the stimulus for new blood vessel formation can travel to the anterior segment of the eye. This triggers new blood vessel formation in the ocular anterior segment and interferes with the normal internal drainage system of the eye leading to elevated Continue reading >>