Diabetes And Vision: Understanding The Link

Diabetes and Vision: Understanding the Link

Uncontrolled blood sugar can affect you from head to toe—including your eyes. Yet Johns Hopkins research shows that many people living with diabetes don’t have their eyes examined or take other steps that can help save their vision.
Fewer than half of all Americans with diabetes-related eye damage know that diabetes can lead to vision loss—and just 60 percent of those in the know had a complete eye exam in the previous year, finds a recent Johns Hopkins study. This “knowledge gap” could increase risk for blindness if people miss out on early eye checks and vision-protecting treatments, the researchers say. In fact, nearly one in four people in this study already had some loss of vision.
It’s well known that diabetes raises your blood sugar levels. But this chronic health condition also increases your risk for eye diseases that can cause blindness, says Johns Hopkins diabetes expert Rita Rastogi Kalyani, M.D., M.H.S.
“Elevated blood sugar levels can damage blood vessels in the retina—the area at the back of the eye that sends signals to your brain,” says Kalyani. “This damage, called diabetic retinopathy, can begin years before you notice vision changes.” The condition can lead to diabetic macular edema, a leading cause of vision loss in people with diabetes.
Diabetic retinopathy is the leading cause of new cases of reversible blindness in the United States. About 40 percent of people with diabetes have some degree of retinopathy, according to the National Institutes of Health’s National Eye Institute. At first, tiny blood vessels in the eye may swell Continue reading

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Type 1 diabetes linked to coeliac disease

Type 1 diabetes is an autoimmune disease that causes the body's immune system to mistakenly attack the insulin-producing cells in the pancreas, according to the American Diabetes Association.
Parents of young children with type 1 diabetes need to be on the lookout for symptoms of another autoimmune condition – coeliac disease, new research suggests.
The study found these youngsters appear to face a nearly tripled risk of developing coeliac disease autoantibodies, which eventually can lead to the disorder, which is chronic and causes an intolerance to gluten, which damages the small intestinal lining. The severity of symptoms differs from person to person.
Genetically related
"Type 1 diabetes and coeliac disease are closely related genetically," explained study author Dr William Hagopian.
"People with one disease tend to get the other. People who have type 1 diabetes autoantibodies should get screened for coeliac autoantibodies," Hagopian said. He directs the diabetes programme at the Pacific Northwest Research Institute in Seattle.
Insulin is a hormone that helps to usher the sugar from foods into the body's cells to be used as fuel. Because the autoimmune attack leaves people with type 1 diabetes without enough insulin, they must replace the lost insulin through injections or an insulin pump with a temporary tube inserted under the skin.
Coeliac disease is an autoimmune disease that causes the immune system to attack the lining of the small intestine when gluten is consumed, according to the Coeliac Disease Foundation. Gluten is a protein found in wheat. Symptoms of coel Continue reading

Decades into diabetes, insulin therapy still hard to manage

So, your doctor told you that you need insulin therapy for your Type 2 diabetes.
This is a common problem and likely to be more so in the coming years. About 29 million people in the U.S. have Type 2 diabetes, and another 86 million have prediabetes. About one in four people with Type 2 diabetes is on insulin therapy, and another one in four likely needs to be.
What does it mean to be on insulin therapy, exactly? And whose fault is it? Could you have prevented this? Will insulin actually work? These are frequent questions people who need insulin therapy ask, and, as someone who has treated people with diabetes for years and has been working to improve its effectiveness, I will do my best to help you answer these questions. I also have been working to develop a better way to personalize dosing for insulin.
Insulin therapy for Type 2 diabetes
Diabetes is a condition in which your pancreas fails to secrete a sufficient amount of insulin to help you to maintain normal blood glucose, or sugar in the blood, which is transported to various parts of our bodies to supply energy.
There are many causes of insulin deficiency, but the most common is Type 2 diabetes. The main risk factors for Type 2 diabetes are family history, weight and age.
In fact, most overweight or obese people in the Western world will never develop diabetes. Weight is a very important, yet misunderstood, risk factor for diabetes. The foods you eat are usually less relevant than the weight itself. The American Diabetes Association, for example, recommends that you limit the amount of sugary drinks you drink, inclu Continue reading

Alzheimer’s: Diabetes of the Brain?

Although we’ve always known that Alzheimer’s disease is typically associated with numerous tangles and plaque in the brain, the exact cause of these abnormalities has been hard to pin down. Now, we may be closer to an answer.
In many respects, Alzheimer’s is a brain form of diabetes. Even in the earliest stages of disease, the brain’s ability to metabolize sugar is reduced. Normally, insulin plays a big role in helping the brain take up sugar from the blood. But, in Alzheimer’s, insulin is not very effective in the brain. Consequently, the brain cells practically starve to death.
How is that like diabetes?
These days, most people with diabetes have Type 2 diabetes mellitus. Basically, cells throughout the body become resistant to insulin signals. In an effort to encourage cells to take up more sugar from the blood, the pancreas increases the output of insulin. Imagine having to knock louder on a door to make the person inside open up and answer. The high levels of insulin could damage small blood vessels in the brain, and eventually lead to poor brain circulation. This problem could partly explain why Type 2 diabetes harms the brain. In Alzheimer’s, the brain, especially parts that deal with memory and personality, become resistant to insulin.
Why does the brain need insulin?
As in most organs, insulin stimulates brain cells to take up glucose or sugar, and metabolize it to make energy. Insulin also is very important for making chemicals known as neurotransmitters, which are needed for neurons to communicate with each other. Insulin also stimulates many function Continue reading

Author Advances Damaging Myth About Diabetes

Jim Hirsch, diaTribe contributor and bestselling author, weighs in on a damaging diabetes myth:
“They’re never going to cure diabetes, because there’s too much money in it.”
This article prompted a letter of complaint from Dr. Denise Faustman, printed below, followed by responses from Jeffrey Brewer and Mr. Hirsch.
I was diagnosed with type 1 diabetes 40 years ago, and I can’t tell you how many times I’ve heard someone say that or words to that effect. It’s understandable. Diabetes is big business, and as the drugs and medical devices have become more sophisticated and expensive each year – and as more people are diagnosed each day – diabetes itself becomes an even bigger business. In the United States, about $200 billion a year is spent in direct costs for diabetes, including hospital and emergency care.
Hence the conclusion: In the view of frustrated patients, family members, and loved ones, there’s just too much money to be made in this disease for a cure to ever be found. Powerful corporate interests will see to that. Even worse: Conspiracy theorists believe that the companies that profit from diabetes are actively thwarting a cure. Or as one person told me, “Eli Lilly has the cure in its vault, but it won’t let it out.”
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I was recently listening to NPR and heard the writer Elisabeth Rosenthal discuss her new book, “American Sickness: How Healthcare Became Big Business and How You Can Take It Back.” The title captures her central theme, that health care in America has been compromised by corporations that have their put their financial i Continue reading