Diabetic Retinopathy

With rise of the epidemic of obesity and diabetes in the USA and around the globe, serious and common diabetic complications are evolving as a major public health problem, particularly among minority populations.1 Hispanics and Latinos are almost 2.5 times more likely to have diabetes, compared to non-Hispanic whites,2 and hence are disproportionately affected by diabetes-related visual complications.

One of the most common visual threatening complications affecting patients with diabetes is diabetic retinopathy. This is the leading cause of blindness in working-age adults in the United States. Diabetic retinopathy is a significant public health issue that is projected to only increase in impact in the coming years, particularly amongst the Hispanic /Latino population.1

A study published in JAMA Ophthalmology, “Prevalence of Diabetic Retinopathy in the US in 2021,” found that in 2021, an estimated 9.6 million people in the United States (26.4 percent of those with diabetes) had diabetic retinopathy (DR), and 1.84 million people (5.1 percent of those with diabetes) had vision-threatening diabetic retinopathy (VTDR). VTDR prevalence rates are higher for Black (8.7 percent) and Hispanic (7.1 percent) individuals than White individuals (3.6 percent). Thus, a higher percentage of Black and Hispanic individuals with diabetes are at risk for vision loss compared to their White counterparts.2

image003
image001

What is Diabetic Retinopathy?

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).  It is the most common cause of vision loss for people with diabetes.3

Risk Factors4

The condition can develop in anyone who has type 1 or type 2 diabetes. The risk of developing the eye condition can increase as a result of:

  • Having diabetes for a long time
  • Poor control of your blood sugar level
  • High blood pressure
  • High cholesterol
  • Pregnancy
  • Tobacco use
  • Being Black, Hispanic or Native American

Additional resources from the National Eye Institute:

Symptoms4

Diabetic retinopathy might cause no symptoms or only mild vision problems. However, as the condition progresses, you might develop:

  • Spots or dark strings floating in your vision (floaters)
  • Blurred vision
  • Fluctuating vision
  • Dark or empty areas in your vision
  • Vision loss
  • Developing diabetes when pregnant (gestational diabetes) or having diabetes before becoming pregnant can increase your risk of diabetic retinopathy. If you're pregnant, your eye doctor might recommend additional eye exams throughout your pregnancy.

Prevention4

You can't always prevent diabetic retinopathy. However, an annual comprehensive dilated eye exam with an eye care provider, along with the following can help reduce your risk of getting diabetic retinopathy, as ell as hep initiate early intervention, when necessary:

  • Manage your diabetes. Make healthy eating and physical activity part of your daily routine. Try to get at least 150 minutes of moderate aerobic activity, such as walking, each week. Take oral diabetes medications or insulin as directed.
  • Monitor your blood sugar level. You might need to check and record your blood sugar level several times a day — or more frequently if you're ill or under stress. Ask your doctor how often you need to test your blood sugar.
  • Ask your doctor about a glycosylated hemoglobin test. The glycosylated hemoglobin test, or hemoglobin A1C test, reflects your average blood sugar level for the two- to three-month period before the test. For most people with diabetes, the A1C goal is to be under 7%.
  • Keep your blood pressure and cholesterol under control. Eating healthy foods, exercising regularly and losing excess weight can help. Sometimes medication is needed, too.
  • If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including diabetic retinopathy.
  • Pay attention to vision changes. Contact your eye doctor right away if your vision suddenly changes or becomes blurry, spotty or hazy.
diabetes-management-traffic-sign-on-blue-sky-289669368

References

  1. Barsegian A, Kotlyar B, Lee J, Salifu MO, McFarlane SI. Diabetic Retinopathy: Focus on Minority Populations. Int J Clin Endocrinol Metab. 2017;3(1):034-45. doi: 10.17352/ijcem.000027. Epub 2017 Nov 11. PMID: 29756128; PMCID: PMC5945200.
  2. “Diabetic Retinopathy,” https://preventblindness.org/diabetic-retinopathy/, accesed 2/25/24
  3. Hispanics and Latinos Have Higher Risk for Vision Loss,”  Centers for Disease Control & Prevention, https://www.cdc.gov/visionhealth/resources/features/hispanic-latino-vision-health.html, Accessed 2/25/24
  4. “At a Glance: Diabetic Retinopathy,” National Eye Institute  https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy, Accessed 2/25/24
  5. “Diabetic Retinopathy,” Mayo Clinic https://www.mayoclinic.org/diseases-conditions/diabetic-retinopathy/symptoms-causes/syc-20371611,  Accessed 2/25/24