Eye Care for PWD

Yes, I used PWD for people or person with diabetes in the title and I am trying to use more acronyms to help people learn them and recognize them when other people use them in articles, blogs, or on social media. I have received emails asking the meaning of a few acronyms.

Yes, I have blogged about eye diseases and diabetes before, but I still receive emails asking if they should take eye diseases seriously. I always answer with the three blogs from January 21 to 23, 2014 and add this to their reading from January 4, 2014 and this blog from January 1, 2016.

I will always write about the same topics that I have written about before when I receive emails asking questions about a topic. I realize that new readers find my blogs and have questions.

To keep your vision sharp, you’ll want to take great care of your health so you can avoid problems related to diabetes. Over time, high blood sugar can damage the tiny blood vessels in your eyes. That can lead to a condition called diabetic retinopathy. High blood sugar can also lead to cataracts and glaucoma, which happen earlier and more often when you have diabetes.

Use these seven tips to take charge of your disease and protect your eyes:

1. Schedule appointments with your eye doctor at least once a year so she can spot any problem early and treat it. During your exam, your eye doctor will use special drops to widen (dilate) your pupils and check the blood vessels in your eyes for early signs of damage.
2. Keep your blood sugar under control. If you do that, you can slow any damage to the tiny blood vessels in your eyes. Several times a year, you should have an A1c blood test. It shows your blood sugar levels over the past 3 months. Your result should be around 6.5% or less.
3. High blood pressure alone can lead to eye disease, so keep it in check. If you have high blood pressure and diabetes, you need to be even more careful about your health. Ask your doctor to check your blood pressure at every visit. For most people with diabetes, it should be less than 140/80.
4. Check on your cholesterol levels. All it takes is a blood test to find out how much “bad” LDL and “good” HDL cholesterol you have. Too much LDL is linked to blood vessel damage.
5. Eat for wellness. Go for fruits, vegetables, and lean protein. If that’s a big change for you, you can get ideas and encouragement from a nutritionist. You can also ask your doctor’s advice about when you should eat and how much is OK if you take insulin.
6. If you smoke, quit. Lighting up causes problems with your blood vessels, which makes you more likely to end up with eye trouble. It’s not easy to kick the habit, so don’t hesitate to ask your doctor for help. Alternatively, go to a support group or quit-smoking program.
7. Move more, if you have no medical limitations. Exercise can have a big influence on blood sugar. If you use insulin or medication to lower your blood sugar, ask your doctor when you should check your levels before and during your workouts. Also ask what type of workout you should do.

There are more ideas and if you have them, do not be afraid to use them as well.

Joint January Meeting

Our January meeting started with Dr. Tom (previously shown as our local doctor) addressing both groups. First, he thanked our group for the impromptu meeting earlier and expressed his thanks to Sue for bringing her relative to be tested and having her depression brought under control without the need for depression drugs. He then turned to his group and told them that thanks to this group including you, many of you will now be tested for different vitamin and mineral deficiencies that would not otherwise be considered deficient.

Next, he explained that the last few months had been intensive and he thanked us for the research we do and to his group, he asked if any of them might be interested in research. Only one person expressed any desire and he was asked to meet with us after the meeting was over.

Tim had been setting up the projector for this Oregon State University website. Dr. Tom said he wanted to start with vitamin B12 and the foods area first within B12. When Tim scrolled to Food Sources, Dr. Tom took time to read it aloud and then emphasized how important the last sentence in the first paragraph should be to everyone. It says, “Individuals over the age of 50 should obtain their vitamin B12 in supplements or fortified foods like fortified cereal because of the increased likelihood of food-bound vitamin B12 malabsorption.”

Then Tim brought up the University of Maryland Medical Center website and scrolled down to the Dietary Sources, which reads, “Vitamin B12 is found only in animal foods. Good dietary sources include fish, shellfish, dairy products, organ meats -- particularly liver and kidney-- eggs, beef, and pork.” Dr. Tom said he understands people that do not like organ meats, as they are not his favorites either. He thanked Tim for doing this as he felt both sources were important. Tim stated that both URLs would be included in the email sent about the meeting.

Dr. Tom then explained that for anyone over the age of 50 that might have fatigue or other problems discussed on either site should not be afraid to ask for the test to determine if they might have a deficiency. He would do the test and felt it was important for people to consider before doing anything about supplements. Then he emphasized that this was important for their doctor to know because of the medication conflicts between vitamin B12 and certain prescription medications, as shown at the bottom of my blog..

After some discussion, Dr. Tom called attention to the Age-Related Macular Degeneration section and told people to read this on both sites. Then he introduced the ophthalmologist and said he would talk about vision and some of the common problems for people with diabetes.

The eye doctor thanked Dr. Tom and then thanked me for inviting him to speak about problems for diabetes affecting eyesight. He explained that I had provided him with my blog on vision and the related websites and this helped explain much of what he would be covering. Next he asked if everyone had diabetes or pre-diabetes. All hands went up and he asked how many had their eyes checked within the last year. Only 16 kept their hands up. He asked if there were some that had eye exam in the last two years – only two.

Then he addressed the seven that had not raised their hands asking how many of them were on Medicare and four raised their hand. He then stated that the American Diabetes Association guidelines stated that two years was now the recommended time between appointments. He said this is not good and you should see your eye doctor for a dilated eye examination at least annually if you are over 50 years of age and annually if certain conditions exist before age 50. With some eye problems, an exam every six months is recommended.

He then asked Tim to start the slides, which showed the eye, and he pointed out what he would be able to see in a dilated eye exam. Some of the slides showed what age-related macular degeneration (AMD) looked like. Then he moved on to cataracts and had several slides showing different aspects of their development. Then he had slides showing what glaucoma looked like. He then concluded with retinopathy and how this looked in the eye exam.

He concluded that of those present, that were his patients, none had retinopathy, several had early stages of cataracts, two were being treated for AMD, and only one had early glaucoma. He then had Tim show the last three slides, which showed advanced glaucoma, cataracts, and AMD. Anyone with these stages can be diagnosed as legally blind. The good news is by discovering them early; treatment can prevent this from happening or delay the serious problem of blindness.

He concluded by saying everyone over the age of 50 should have a dilated eye exam on an annual basis if they have diabetes. Medicare does cover most of the cost and will pay for most treatments. He finished that his office will work with people that are not covered by insurance and do their best for them in getting them help. Discussion and questions followed and he took a few people aside to talk privately with them. The meeting ended and the Dr. Tom asked several of us to talk with the one interested in doing research.

The eye doctor asked if I would be writing more blogs on the eye diseases and I said I was thinking seriously about this. Since he has my address and email address he asked which format I would prefer. I said email if he didn't mind. He indicated that he had several URLs that he would send me and if I could use them he would send several images as well. We agreed and the meeting was over.