World Diabetes Day: the disease, its effect on vision and the family’s role
Diabetes is a chronic disease whose complications can lead to various eye pathologies, such as diabetic retinopathy or macular oedema, in addition to increasing the risk of glaucoma and cataracts. To mark World Diabetes Day, we at the Institut de la Màcula stress the importance of periodic checks
Diabetes mellitus is a chronic disease that over half a million people suffer in Catalonia, and about six million throughout Spain. It occurs when the pancreas cannot make enough insulin or when the latter does not work in the body because cells do not respond to its stimulus.
To increase global awareness about this disease, the World Health Organisation (WHO) and the International Diabetes Federation (IDF) created World Diabetes Day, which is celebrated every November 14. This year, the campaign focuses on the family and diabetes: the impact of the pathology on those who surround sufferers and how it affects them. It also promotes the role of the family in the management of diabetes care, prevention and education.
The environment of diabetic patients, especially the close family, plays a very important role in their health. The right diet and regular physical activity are essential for the control of hyperglycaemia and family support is necessary to make these habits a daily routine. In addition, relatives should be aware of the patient’s needs in terms of medical visits, treatments, expenses and possible work absences arising from this chronic disease. The commitment of family members in the medium and long term is indispensable support for those affected.
The Institut de la Màcula, an ophthalmological centre that is an international benchmark, acknowledges the key role of families in supporting patients and in the monitoring of medical controls, underlining their importance for early diagnosis.
It should be noted that diabetes is an important risk factor in many pathologies and it may also have serious consequences on the field of vision: diabetic retinopathy and diabetic macular oedema are the main ocular conditions.
Diabetic retinopathy is one of the major causes of blindness and it occurs when diabetes makes the blood vessels of the retina very permeable and they lose fluids; these include small amounts of blood and occasionally losses of fat deposits, which causes the macula to swell; in severe cases, there can be vitreous haemorrhages and retinal detachments. When someone develops the symptoms often irreversible damage has already occurred so it is essential to conduct periodic checks that enable the problem to be detected in time and treated.
The possibility of developing diabetic retinopathy increases with the duration of systemic disease. According to different studies, 25% of those who suffer from type I diabetes will develop it in the first five years following diagnosis, this percentage rising to 35% in the case of type II diabetes. Over time, the risk increases to 75% in the former and 55% in the latter.
Diabetic macular oedema, which affects one in ten diabetics in Spain, is caused by an accumulation of fluid in the macula. It is painless and may display few symptoms at the start, mainly blurred and discoloured vision, but it must be treated in time to avoid irreversible degenerative changes.
However, as explained by the optician-optometrist and diabetic Miquel González, neglect is a reason why diabetics do not monitor themselves properly. “Usually, people only go to the doctor when something hurts. We have to work hard on this aspect and underline the importance of periodic check-ups to avoid late detection of an eye problem”, he says.
The President of the Catalonia Diabetes Association (CDA), Francesc Fernández Barqué underlines the importance of diabetics keeping glycaemic values as stable as possible, since this way we can delay the occurrence of possible complications. It also considers periodic checks as essential.
The Director of the Institut de la Màcula, Jordi Monés, MD, PhD, says: “Early detection enables us to act quickly and we now have many treatments that have fully improved the options that existed previously”.
To prevent retinal disease or address it as quickly as possible, Marc Biarnés, OD, MPH, PhD, points out that “it is advisable for diabetics who have not been diagnosed with retinopathy to undergo ophthalmological examinations once a year. If they develop it, the examinations would be scheduled according to degree of severity so that they can be monitored”.