Diabetic Eye Disease: Diagnosis, Causes, And Symptoms
By Debra A. Sokol-McKay, MS, CVRT, CDE, CLVT, OTR/L, SCLV Diagnosing Diabetic Eye Disease How Diabetes Affects the Eyes and Vision: Diabetic Retinopathy Eye Examination Guidelines Diagnosing Diabetic Eye Disease Diabetic retinopathy usually has no early warning signs. It can be detected only through a comprehensive eye examination that looks for early signs of the disease, including: Leaking blood vessels Macular edema (swelling) Pale, fatty deposits on the retina Damaged nerve tissue Any changes to the retinal blood vessels To diagnose diabetic eye disease effectively, eye care specialists recommend a comprehensive diabetic eye examination that includes the following procedures: Distance and near vision acuity tests A dilated eye (or fundus) examination, which includes the use of an ophthalmoscope. In a dilated eye examination, it is the pupil that is dilated—not the entire eye. This allows the examiner to see through the pupil to the retina. Visual acuity tests alone are not sufficient to detect diabetic retinopathy in its early stages. A tonometry test to measure fluid pressure inside the eye. A fluorescein angiography test, if more serious retinal changes, such as macular edema, are suspected. Fluorescein angiography is an eye test that uses a special dye and camera to look at blood flow in the retina. Optical coherence tomography (OCT) testing may be used to gain a clearer picture of the retina and its supporting layers. OCT is a type of medical imaging technology that produces high-resolution cross-sectional and three-dimensional images of the eye. Also, an Amsler Grid test can detect early and sometimes subtle visual changes in a variety of macular diseases, including diabetic macular edema. The first image below shows an Amsler Grid as seen with unimpaired vis Continue reading >>
Signs Of Nephropathy May Occur Early In Young Adults With Diabetes Despite Modern Diabetes Management
Results from the nationwide population-based Diabetes Incidence Study in Sweden (DISS) Abstract OBJECTIVE—To estimate the occurrence of early-onset renal involvement in a nationwide population-based cohort of young adults with diabetes in Sweden and relate the findings to glycemic control, type of diabetes, sex, smoking, and blood pressure. RESEARCH DESIGN AND METHODS—The Diabetes Incidence Study in Sweden aims to register all incident cases of diabetes in the age-group 15–34 years. In 1987–1988, 806 patients were reported and invited to participate in a follow-up study focusing on microvascular complications. Of them, 469 subjects participated. The assessment was based on questionnaires (n = 469), blood samples (n = 424), urine samples (n = 251) and, when appropriate, medical records (n = 186). RESULTS—During the follow-up time, median 9 years (range 6–12), 31 of 469 patients (6.6%) with incipient or overt diabetic nephropathy (i.e., micro- or macroalbuminuria) were found, 24 of 426 (5.6%) in type 1 and 7 of 43 (16%) in type 2 diabetic subjects (P = 0.016). Additionally, 24 of 31 patients (77%) had microalbuminuria and 7 (23%) had macroalbuminuria, which mainly occurred in patients with type 2 diabetes. In a Cox regression analysis, high mean HbA1c during the follow-up period and high blood pressure at follow-up increased the risk of developing signs of nephropathy (P = 0.020 and P = 0.003, respectively). Compared with patients with type 1 diabetes, those with type 2 diabetes tended to have an increased risk of renal involvement (P = 0.054) when adjusting for sex, tobacco use, glycemic control, and blood pressure. CONCLUSIONS—Despite modern treatment and self-monitoring of blood glucose, young adult patients with diabetes may still develop renal involveme Continue reading >>
Clinical Presentation And Diagnosis Of Diabetes Mellitus In Adults
INTRODUCTION The term diabetes mellitus describes several diseases of abnormal carbohydrate metabolism that are characterized by hyperglycemia. It is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin. Every few years, the diabetes community reevaluates the current recommendations for the classification, diagnosis, and screening of diabetes, reflecting new information from research and clinical practice. The American Diabetes Association (ADA) issued diagnostic criteria for diabetes mellitus in 1997, with follow-up in 2003 and 2010 [1-3]. The diagnosis is based on one of four abnormalities: glycated hemoglobin (A1C), fasting plasma glucose (FPG), random elevated glucose with symptoms, or abnormal oral glucose tolerance test (OGTT) (table 1). Patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are referred to as having increased risk for diabetes or prediabetes. (See 'Diagnostic criteria' below.) Screening for and prevention of diabetes is reviewed elsewhere. The etiologic classification of diabetes mellitus is also discussed separately. (See "Screening for type 2 diabetes mellitus" and "Prevention of type 2 diabetes mellitus" and "Prevention of type 1 diabetes mellitus" and "Classification of diabetes mellitus and genetic diabetic syndromes".) CLINICAL PRESENTATION Type 2 diabetes is by far the most common type of diabetes in adults (>90 percent) and is characterized by hyperglycemia and variable degrees of insulin deficiency and resistance. The majority of patients are asymptomatic, and hyperglycemia is noted on routine laboratory evaluation, prompting further testing. The frequency of symptomatic diabetes has been decreasing in parallel wi Continue reading >>
Diabetic Eye Disease
A A A Do I need to follow-up with my doctor after being diagnosed with diabetic eye disease? Diabetes is one of the leading causes of irreversible blindness worldwide, and, in the United States, it is the most common cause of blindness in people younger than 65 years of age. Diabetic eye disease also encompasses a wide range of other eye problems, for example, Diabetes may cause a reversible, temporary blurring of the vision, or it can cause a severe, permanent loss of vision. Some people may not even realize they have had diabetes for several years until they begin to experience problems with their eyes or vision. Diabetes also may result in heart disease, stroke, kidney failure, and circulatory abnormalities of the legs. The American Diabetes Association estimates that 29.1 million people in the United States have diabetes, and 8.1 million people additional people went undiagnosed. (This population is unaware that they have diabetes.) In the United States 1.2 million new cases of diabetes are diagnosed every year. In the US in 2012, the total annual cost of diagnosed diabetes was 2.45 billion. Eighty-six million people in the US have prediabetes, and 9 out of every 10 don't know they have it. Of the 86 million people with prediabetes, without lifestyle changes 15% to 30% of them will develop type 2 diabetes within 5 years. Lifestyle management has been shown to reduce the risk of developing type 2 diabetes and prediabetes by at least two-thirds. It can also slow or halt the progression of prediabetes to diabetes. People can try to avoid the problems associated with diabetes, including those that affect the eyes, by taking appropriate care of themselves by the following: Maintain a normal level of weight Watch your diet, especially limiting unhealthy types of fats and Continue reading >>
What Is Diabetic Retinopathy?
Diabetes is a condition marked by high levels of blood glucose resulting from the body’s inability to produce or use insulin. Low vision is just one of the serious complications. Others include heart disease, stroke, hypertension, kidney disease and nerve disease, which can lead to amputation. Diabetic retinopathy is an eye disease resulting from diabetes. It is the leading cause of new diagnoses of blindness in Americans ages 20 to 74. Every diabetic is at risk. Between 40 and 45 percent of all diabetics will suffer from diabetic retinopathy to some degree. Over 14 million adults over 40 are predicted to have diabetic retinopathy by 2050. Because of excess blood sugar, diabetic retinopathy damages small blood vessels lining the retina, the light-sensitive tissue at the back of the eye, impairing vision. The negative effects on daily activities of living such as reading, driving, exercising and many other tasks often taken for granted can be overwhelming. The damage can affect your central and peripheral vision, including the ability to resolve small detail, eyes working together, depth and color perception and contrast sensitivity. Diabetic retinopathy can also result in other vision conditions such as cataracts and glaucoma. Like many debilitating effects of diabetes, the damage can be limited or prevented by following a doctor’s plan of care. Learning to control your blood sugar levels through medicine, diet and exercise and managing your blood pressure and cholesterol are essential to managing diabetes. Regular, thorough eye exams, including dilated eye evaluations, should also be a part of your plan of care. Even mild visual impairments can significantly reduce your daily activities. Low vision rehabilitation can improve your visual function and restore your in Continue reading >>
Diabetes Symptoms And Warning Signs For Older Adults
Mary Alexander of Home Instead Senior Care discusses the symptoms and warning signs of diabetes in older adults. Videos in this Series Continue reading >>
Diabetes Symptoms & Warning Signs For Older Adults: Diabetes (3 Of 6)
Diabetes often goes undiagnosed, because many of its symptoms seem so harmless. And in many cases, people with type-2 diabetes display no symptoms at all. For both type-1 and type-2 diabetes, there are several symptoms in common. Be sure to pay attention to the signals your body sends, and see your doctor if any of these symptoms start to appear. Get notified by email when new videos are released. Continue reading >>
About Diabetes
Diabetes is a chronic (long-lasting) disease that affects how your body turns food into energy. Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream. Your pancreas makes a hormone called insulin, which acts like a key to let the blood sugar into your body’s cells for use as energy. If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it makes as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream, which over time can cause serious health problems, such as heart disease, vision loss, and kidney disease. There isn’t a cure yet for diabetes, but healthy lifestyle habits, taking medicine as needed, getting diabetes self-management education, and keeping appointments with your health care team can greatly reduce its impact on your life. 30.3 million US adults have diabetes, and 1 in 4 of them don’t know they have it. Diabetes is the seventh leading cause of death in the US. Diabetes is the No. 1 cause of kidney failure, lower-limb amputations, and adult-onset blindness. In the last 20 years, the number of adults diagnosed with diabetes has more than tripled as the American population has aged and become more overweight or obese. Types of Diabetes There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant). Type 1 diabetes is caused by an autoimmune reaction (the body attacks itself by mistake) that stops your body from making insulin. About 5% of the people who have diabetes have type 1. Symptoms of type 1 diabetes often develop quickly. It’s usually diagnosed in children, teens, and young adults. If you have type 1 diabetes, you’ll need t Continue reading >>
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What Are The Symptoms Of A Diabetic Emergency?
Diabetes is becoming a more common disease, now affecting 23.6 million children and adults in the United States, according to the American Diabetes Association. There are several types of diabetes, and once diagnosed, your physician will educate and monitor you closely to ensure optimal and safe health care for your condition. Knowing the symptoms of a diabetic emergency is useful whether you suffer from the disease yourself, have a friend or family member with the condition or happen upon a stranger in a diabetic crisis. All diabetic emergencies require immediate medical attention. If you experience a diabetic emergency firsthand, or are providing care for someone who is, call 911 immediately. Video of the Day Hypoglycemia is a condition in which someone is suffering from dangerously low levels of blood sugar. For someone who is diabetic, this usually results from taking too much insulin or not eating properly. The sugar found in the blood is a necessary food for the brain and other organs to function properly and low bood sugar needs to be treated immediately. Symptoms of hypoglycemia include cold and clammy skin, confusion, poor balance, feeling faint and rapid heartbeat. Call 911, and while waiting for the ambulance provide sugary drinks such as orange juice and soda, or place pure sugar under the tongue and inside the mouth. If the person has become unconscious, only put the a small amount of sugar under the tongue and along the inside of the cheeks, while rolling the person onto their side. Monitor them to ensure choking does not result. Hyperglycemia is when blood sugar levels are excessively high. The symptoms are very similar to hypoglycemia and are often confused before medical treatment is received. If you are in doubt to which scenario a diabetic is sufferin Continue reading >>
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) happens when your blood sugar is high and your insulin level is low. This imbalance in the body causes a build-up of ketones. Ketones are toxic. If DKA isn’t treated, it can lead to diabetic coma and even death. DKA mainly affects people who have type 1 diabetes. But it can also happen with other types of diabetes, including type 2 diabetes and gestational diabetes (during pregnancy). DKA is a very serious condition. If you have diabetes and think you may have DKA, contact your doctor or get to a hospital right away. The first symptoms to appear are usually: frequent urination. The next stage of DKA symptoms include: vomiting (usually more than once) confusion or trouble concentrating a fruity odor on the breath. The main cause of DKA is not enough insulin. A lack of insulin means sugar can’t get into your cells. Your cells need sugar for energy. This causes your body’s glucose levels to rise. To get energy, the body starts to burn fat. This process causes ketones to build up. Ketones can poison the body. High blood glucose levels can also cause you to urinate often. This leads to a lack of fluids in the body (dehydration). DKA can be caused by missing an insulin dose, eating poorly, or feeling stressed. An infection or other illness (such as pneumonia or a urinary tract infection) can also lead to DKA. If you have signs of infection (fever, cough, or sore throat), contact your doctor. You will want to make sure you are getting the right treatment. For some people, DKA may be the first sign that they have diabetes. When you are sick, you need to watch your blood sugar level very closely so that it doesn’t get too high or too low. Ask your doctor what your critical blood sugar level is. Most patients should watch their glucose levels c Continue reading >>
6 Signs Your Type 2 Diabetes Might Really Be Type 1
Reviewed by endocrinologist Stanley S. Schwartz, MD, emeritus Associate Professor of Medicine at the University of Pennsylvania and George Grunberger, MD, FACP, FACE, Chairman of the Grunberger Diabetes Institute, Clinical Professor of Internal Medicine and Molecular Medicine & Genetics at Wayne State University School of Medicine and President of the American Association of Clinical Endocrinologists. Up to 10%1 of people with type 2 diabetes may actually have a form of diabetes known as latent autoimmune diabetes in adults, or LADA, where the immune system slowly destroys insulin-producing beta cells. That’s the conclusion of a string of studies that have looked at this mysterious high blood sugar problem since it was first recognized by Scottish endocrinologists in the late 1970s.2 Yet 39 years later, most of the estimated 3 million or more Americans with LADA think they’ve got type 2 diabetes. That misdiagnosis can cause frustration, misunderstandings and even health problems, says endocrinologist Stanley S. Schwartz, MD, an emeritus Associate Professor of Medicine at the University of Pennsylvania. “If your doctor is not thinking about the possibility of LADA, he or she may not prescribe the diabetes drugs early on that could help extend the life of your insulin-producing beta cells,” Dr. Schwartz says. “With LADA, you lose the ability to produce insulin much more quickly than the typical type 2. But a doctor who believes you’re a type 2 may hesitate to prescribe insulin when your blood sugar levels rise, thinking that a healthier lifestyle and higher doses of other medications will work.” As a result, your blood sugar could skyrocket, increasing your risk for diabetes complications, says George Grunberger, MD, FACP, FACE, Chairman of the Grunberger Di Continue reading >>
How To Tell If You Have Type 2 Diabetes
Many people have type 2 diabetes and don’t realise. This is because symptoms don’t necessarily make you feel unwell. Symptoms of type 2 diabetes include: peeing more than usual, particularly at night feeling thirsty all the time feeling very tired losing weight without trying itching around your penis or vagina, or you keep getting thrush cuts or wounds that take longer to heal blurred vision You’re more at risk of developing type 2 diabetes if you: are over 40 (or 25 for South Asian people) have a close relative with diabetes (parent, brother or sister) are overweight or obese are of South Asian, Chinese, African-Caribbean or black African origin (even if you were born in the UK) When to see your GP See your GP if you have any of the symptoms of type 2 diabetes, or you’re worried you may have a higher risk of developing it. Your GP can diagnose diabetes. You’ll need a blood test which you may have to go to your local health centre for if it can’t be done at your GP surgery. The earlier diabetes is diagnosed and treatment starts, the better. Treating diabetes early reduces your risk of other health problems. Type 2 diabetes is often diagnosed following blood or urine tests for something else. However, if you have any symptoms of diabetes you should see your GP straight away. To find out if you have type 2 diabetes, you usually have to go through the following steps: Speak to your GP about your symptoms. Your GP will check your urine and arrange a blood test to check your blood sugar levels. It usually takes about 1 to 2 days for the results to come back. If you have diabetes, your GP will ask you to come in again to explain the test results and what will happen next. If you’re diagnosed with diabetes What your GP will discuss with you during your appointme Continue reading >>
Nondiabetic Hypoglycemia
What is non-diabetic hypoglycemia? Hypoglycemia is the condition when your blood glucose (sugar) levels are too low. It happens to people with diabetes when they have a mismatch of medicine, food, and/or exercise. Non-diabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes. There are two kinds of non-diabetic hypoglycemia: Reactive hypoglycemia, which happens within a few hours of eating a meal Fasting hypoglycemia, which may be related to a disease Glucose is the main source of energy for your body and brain. It comes from what we eat and drink. Insulin, a hormone, helps keep blood glucose at normal levels so your body can work properly. Insulin’s job is to help glucose enter your cells where it’s used for energy. If your glucose level is too low, you might not feel well. What causes non-diabetic hypoglycemia? The two kinds of non-diabetic hypoglycemia have different causes. Researchers are still studying the causes of reactive hypoglycemia. They know, however, that it comes from having too much insulin in the blood, leading to low blood glucose levels. Types of nondiabetic hypoglycemia Reactive hypoglycemia Having pre-diabetes or being at risk for diabetes, which can lead to trouble making the right amount of insulin Stomach surgery, which can make food pass too quickly into your small intestine Rare enzyme deficiencies that make it hard for your body to break down food Fasting hypoglycemia Medicines, such as salicylates (such as aspirin), sulfa drugs (an antibiotic), pentamidine (to treat a serious kind of pneumonia), quinine (to treat malaria) Alcohol, especially with binge drinking Serious illnesses, such as those affecting the liver, heart, or kidneys Low levels of certain hormones, such as cortisol, growth hormone, glu Continue reading >>
Most Common Early Symptoms Of Diabetes Type 2
There are various types of diabetes, but the vast majority of people, in fact, more than 90 percent suffer from type 2 diabetes(“WHO | Diabetes,” n.d.). Type 2 diabetes is rising, and has become an epidemic of the 21st century(Jaacks, Siegel, Gujral, & Narayan, 2016), in fact in many countries almost one-tenth of the population have become diabetic(“IDF diabetes atlas – Home,” n.d.). It is a disease of faulty lifestyle. Thus the key to prevention of this disease lies in its early diagnosis and lifestyle correction. Almost one-third of people suffering from diabetes remain undiagnosed even in advanced western societies(“One-Third of Adults with Diabetes Still Don’t Know They Have It,” 2015), this percentage is much higher in developing nations(“IDF diabetes atlas – Home,” n.d.). The vast majority of people suffering from diabetes are diagnosed just by chance when they come to a physician with some other symptom or health disease condition. Because diabetes is often diagnosed at the phase when complications have arisen(American Diabetes Association, 2004), thus in a significant number of cases, the precious chance of early diabetes diagnosis and prevention is lost. Hence everyone got to know the beginning of the signs, which may be quite vague, but indicate the initial stages of diabetes. First and foremost, 3 important early signs of diabetes are so called 3Ps (polyphagia, polyuria, and polydipsia), simply put the person suffering from diabetes, eats more, drinks more and pees more. Added to it are various other equally important signs to look for(“Symptoms & Causes of Diabetes | NIDDK,” n.d.). Polyphagia- desire to eat more In the early stages of diabetes, when your body is unable to control the glucose levels properly, or unable to either rele Continue reading >>
Type 1 Diabetes In Children
What is type 1 diabetes? Type 1 diabetes is an autoimmune disease that causes an unhealthy amount of a simple sugar (glucose) to build up in a person's blood. Someone with type 1 diabetes can't produce enough insulin, a hormone that moves glucose from the bloodstream into cells throughout the body, where it supplies energy and fuels growth. Normally, a child's immune system protects her body from diseases by destroying unhealthy cells and germs. But when a child has type 1 diabetes, her body also mistakenly attacks the healthy insulin-producing cells of the pancreas (a gland behind the stomach). Without these cells, her pancreas produces very little or no insulin, which leads to an abnormally high amount of sugar in her blood. Without proper care, type 1 diabetes can cause serious, wide-ranging health problems that can damage organs throughout the body over the long-term. If your child has been diagnosed with type 1 diabetes, it's understandable that you might worry. But diabetes can be kept under control by carefully monitoring your child's blood sugar and following her treatment plan. A team of doctors, nurses, and nutritionists can help your child be as healthy as possible and teach her to manage the condition so she stays that way. What are the symptoms of type 1 diabetes in children? Symptoms of type 1 diabetes include: Extreme thirst Peeing more than usual (You might notice more wet diapers if your child is very young, or "accidents" if your child is potty trained.) Extreme hunger Weight loss Unusual tiredness Crankiness Yeast infection or diaper rash If your child has one or more of these symptoms, call his doctor right away. Type 1 diabetes symptoms can start quickly and become very serious without treatment. Get medical care immediately if your child has any of Continue reading >>
